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The procedure described by CPT® Code 50542 involves a laparoscopic surgical technique aimed at ablating renal mass lesions. Ablation refers to the destruction of tissue, in this case, cysts or mass lesions located in the kidney. The physician utilizes various methods to achieve this destruction, which may include cryoablation, radiofrequency ablation (RFA), high-intensity focused ultrasound (HIFU), or laser thermal ablation. The laparoscopic approach allows for minimally invasive access to the kidney, which is achieved by creating a pneumoperitoneum and inserting trocars. The laparoscope is introduced through the umbilical port, providing visualization of the kidney and its lesions. Once the lesions are identified, specific ablation instruments are employed to treat them. The procedure is carefully monitored, particularly in the case of cryoablation, where ultrasound guidance is used to ensure that the freezing effect adequately encompasses the lesion. This meticulous approach helps to minimize damage to surrounding healthy tissue while effectively treating the targeted lesions. Following the ablation, the surgical instruments are removed, and any necessary drains are placed before closing the incisions. This procedure is specifically coded as 50542 for the ablation of renal mass lesions, distinguishing it from other codes that may pertain to different types of renal ablation procedures.
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The procedure is indicated for the treatment of renal mass lesions, which may include various types of cysts or tumors within the kidney. The specific indications for performing laparoscopic ablation include:
The laparoscopic ablation of renal mass lesions involves several key procedural steps, which are detailed as follows:
Post-procedure care involves monitoring the patient for any complications that may arise following the laparoscopic ablation. Patients may require observation for bleeding or infection at the incision sites. The recovery process typically includes managing pain and ensuring that any drains placed during the procedure are functioning properly. Follow-up appointments may be scheduled to assess the success of the ablation and to monitor the patient's overall kidney function and health status. It is essential for the healthcare team to provide instructions regarding activity restrictions and signs of potential complications that the patient should be aware of during their recovery.
| Short Descr | LAPARO ABLATE RENAL MASS | Medium Descr | LAPS ABLTJ RENAL MASS LESION W/INTRAOP US | Long Descr | Laparoscopy, surgical; ablation of renal mass lesion(s), including intraoperative ultrasound guidance and monitoring, when performed | Status Code | Active Code | Global Days | 090 - Major Surgery | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 2 - Standard payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 1 - 150% payment adjustment for bilateral procedures applies. | 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 | Hospital Part B services paid through a comprehensive APC | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P8I - Endoscopy - other | MUE | 1 | CCS Clinical Classification | 112 - Other OR therapeutic procedures of urinary tract |
This is a primary code that can be used with these additional add-on codes.
| 49327 | Addon Code MPFS Status: Active Code APC N ASC N1 Laparoscopy, surgical; with placement of interstitial device(s) for radiation therapy guidance (eg, fiducial markers, dosimeter), intra-abdominal, intrapelvic, and/or retroperitoneum, including imaging guidance, if performed, single or multiple (List separately in addition to code for primary procedure) |
| 22 | Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service. | 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). | 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. | 78 | Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.) | 79 | Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.) | 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). | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | GC | This service has been performed in part by a resident under the direction of a teaching physician | LT | Left side (used to identify procedures performed on the left side of the body) | RT | Right side (used to identify procedures performed on the right side of the body) | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
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| 2011-01-01 | Changed | Long description revised. Medium description changed. Guideline information changed. |
| 2003-01-01 | Added | First appearance in code book in 2003. |
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