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The procedure described by CPT® Code 50329 involves the backbench reconstruction of a renal allograft, which can be sourced from either a cadaver or a living donor, prior to its transplantation into a recipient. This specific procedure focuses on the ureteral anastomosis, which is the surgical connection of the ureter from the donor kidney to the recipient's urinary system. Such reconstruction is often necessary when the donor kidney exhibits anatomical anomalies, such as the presence of double ureters, which can complicate the transplantation process. During the procedure, the ureter is meticulously dissected from the surrounding tissues, ensuring that the vascular supply to the kidney is preserved to maintain its viability. A patch or graft is typically prepared, often utilizing a segment of the recipient's ureter, which is then anastomosed, or surgically joined, to the donor ureter. In cases where double ureters are present, the surgical team may choose to anastomose the two ureters together or prepare each ureter separately for graft anastomosis. It is important to report CPT® Code 50329 for each ureteral anastomosis that is performed during this complex surgical procedure.
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The backbench reconstruction of a renal allograft, as described by CPT® Code 50329, is indicated in specific scenarios where anatomical anomalies of the donor kidney necessitate surgical intervention prior to transplantation. The following conditions may warrant this procedure:
The procedure for backbench reconstruction of the renal allograft involves several critical steps to ensure the successful anastomosis of the ureter. The following procedural steps are outlined:
After the backbench reconstruction procedure is completed, careful monitoring and post-operative care are essential to ensure the success of the transplant. The recipient will typically be observed for any signs of complications, such as leakage or obstruction at the anastomosis site. Additionally, the surgical team will provide specific instructions regarding follow-up care, including medication management and monitoring for signs of rejection or infection. The overall recovery process will depend on the individual patient's condition and the complexity of the surgical procedure performed.
| Short Descr | PREP RENAL GRAFT/URETERAL | Medium Descr | BKBENCH RCNSTJ ALGRFT URETERAL ANAST EA | Long Descr | Backbench reconstruction of cadaver or living donor renal allograft prior to transplantation; ureteral anastomosis, each | Status Code | Active Code | Global Days | XXX - Global Concept Does Not Apply | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 2 - Standard payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 2 - Payment restriction for assistants at surgery does not apply to this procedure... | Co-Surgeons (62) | 1 - Co-surgeons could be paid, though supporting documentation is required... | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Inpatient Procedures, not paid under OPPS | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P1G - Major procedure - Other | MUE | 1 | CCS Clinical Classification | 104 - Nephrectomy, partial or complete |
| 51 | Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d). | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | 58 | Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78. | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | 62 | Two surgeons: when 2 surgeons work together as primary surgeons performing distinct part(s) of a procedure, each surgeon should report his/her distinct operative work by adding modifier 62 to the procedure code and any associated add-on code(s) for that procedure as long as both surgeons continue to work together as primary surgeons. each surgeon should report the co-surgery once using the same procedure code. if additional procedure(s) (including add-on procedure(s) are performed during the same surgical session, separate code(s) may also be reported with modifier 62 added. note: if a co-surgeon acts as an assistant in the performance of additional procedure(s), other than those reported with the modifier 62, during the same surgical session, those services may be reported using separate procedure code(s) with modifier 80 or modifier 82 added, as appropriate. | 80 | Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s). | 82 | Assistant surgeon (when qualified resident surgeon not available): the unavailability of a qualified resident surgeon is a prerequisite for use of modifier 82 appended to the usual procedure code number(s). | GC | This service has been performed in part by a resident under the direction of a teaching physician | RT | Right side (used to identify procedures performed on the right side of the body) |
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| 2005-01-01 | Added | First appearance in code book in 2005. |
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