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An ureterolithotomy is a surgical procedure specifically designed to remove a calculus, commonly referred to as a stone, from the ureter, which is the tube that carries urine from the kidney to the bladder. This procedure is indicated when a stone obstructs the ureter, causing pain, infection, or other complications. The surgery involves making an incision in the abdomen, which may be located over the upper, middle, or lower ureter, depending on the precise location of the stone. During the operation, the abdominal wall muscles are carefully divided, and the peritoneum, the lining of the abdominal cavity, is pushed aside to access the ureter. Once the ureter is identified, it is meticulously dissected free from surrounding tissues, including the serosa and periureteral fat. The surgeon locates the stone by either observing a bulge in the ureter or by palpating the ureter manually. To facilitate the removal of the stone, vascular loops are placed above and below the stone to immobilize it. The ureter is then incised directly over the stone, allowing for its extraction. After the stone is removed, a catheter is inserted into the ureter for irrigation, ensuring that any remaining fragments are cleared. A soft Penrose drainage tube or suction tube is placed to drain the ureter, and the incision in the ureter is carefully closed to avoid constriction. Finally, a drainage tube is positioned, and the abdominal incision is closed around the drain. This procedure is specifically coded as CPT® 50610 when the stone is removed from the upper one-third of the ureter, with different codes designated for stones located in the middle and lower thirds of the ureter.
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The ureterolithotomy procedure is indicated for the following conditions:
The ureterolithotomy procedure involves several critical steps to ensure the successful removal of the stone from the ureter:
After the ureterolithotomy, patients are typically monitored for any complications related to the surgery. Post-procedure care may include managing pain, monitoring for signs of infection, and ensuring proper drainage from the ureter. Patients may be advised to follow up with their healthcare provider to assess recovery and the effectiveness of the stone removal. It is essential to observe for any urinary complications or recurrence of stones, and further imaging may be required to ensure the ureter is functioning correctly post-surgery.
| Short Descr | REMOVAL OF URETER STONE | Medium Descr | URTROLITHOTOMY UPPER ONE-THIRD URETER | Long Descr | Ureterolithotomy; upper one-third of ureter | 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 | 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 | 112 - Other OR therapeutic procedures of urinary tract |
| 50 | Bilateral procedure: unless otherwise identified in the listings, bilateral procedures that are performed at the same session, should be identified by adding modifier 50 to the appropriate 5 digit code. note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 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). | 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. | 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) |
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| 2011-01-01 | Changed | Medium description changed. |
| Pre-1990 | Added | Code added. |
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