© Copyright 2025 American Medical Association. All rights reserved.
An ureterolithotomy is a surgical procedure specifically designed to remove a calculus, commonly referred to as a stone, from the ureter, which is the duct that carries urine from the kidney to the bladder. This procedure is particularly focused on the lower one-third of the ureter. During the operation, a surgical incision is made in the abdomen, strategically located over the upper, middle, or lower ureter, depending on the precise location of the stone. The surgical team carefully divides the muscles of the abdominal wall and displaces the peritoneum, which is the lining of the abdominal cavity, to gain access to the ureter. Once the ureter is identified, it is meticulously dissected free from the surrounding serosa and periureteral fat to ensure a clear view and access to the stone. The surgeon then locates the stone, which may be identified by a visible bulge in the ureter or through manual palpation. To facilitate the removal of the stone, vascular loops are placed above and below the stone to immobilize it. An incision is made directly over the stone, allowing for its removal. Following the extraction, a catheter is inserted into the ureter for irrigation, ensuring that any remaining stone fragments are cleared. A soft Penrose drainage tube or suction tube is then placed to drain the ureter. The ureter incision is carefully closed, ensuring that it does not constrict the ureter, and a drainage tube is positioned before the abdominal incision is closed around the drain. This procedure is critical for alleviating the obstruction caused by ureteral stones and restoring normal urinary function.
© Copyright 2025 Coding Ahead. All rights reserved.
The ureterolithotomy procedure is indicated for the removal of calculi or stones located in the lower one-third of the ureter. This surgical intervention is typically performed when non-invasive methods, such as lithotripsy or ureteroscopy, are not feasible or have failed to effectively remove the stone. The presence of a stone causing obstruction, pain, or infection in the urinary tract may also warrant this procedure.
The ureterolithotomy procedure involves several critical steps to ensure the successful removal of the stone from the lower one-third of the ureter. Initially, the patient is positioned appropriately, and an incision is made in the abdomen over the targeted area of the ureter. This incision allows access to the ureter, where the abdominal wall muscles are carefully divided, and the peritoneum is pushed aside to expose the ureter. Once the ureter is accessible, the surgeon identifies and dissects it free from the surrounding serosa and periureteral fat, ensuring a clear view of the ureter and the stone. The stone is located either by visual inspection, which may reveal a bulge in the ureter, or by palpation, where the surgeon feels for the stone manually. To facilitate the removal of the stone, vascular loops are placed above and below the stone to immobilize it, preventing movement during the procedure. The surgeon then makes an incision directly over the stone, allowing for its extraction. After the stone is removed, a catheter is inserted into the ureter to irrigate the area, ensuring that any remaining fragments are cleared. Following this, a soft Penrose drainage tube or suction tube is placed to facilitate drainage from the ureter. The incision in the ureter is then carefully closed, taking special care to avoid constricting the ureter, which could lead to complications. Finally, a drainage tube is positioned, and the abdominal incision is closed around the drain, completing the procedure.
After the ureterolithotomy, patients are typically monitored for any signs of complications, such as infection or bleeding. Post-procedure care may include pain management, hydration, and monitoring of urinary output to ensure proper kidney function. Patients may also be advised to follow up with their healthcare provider to assess recovery and to check for any remaining stones or complications. The presence of a drainage tube may require specific care instructions to prevent infection and ensure proper drainage. Recovery time can vary based on individual patient factors and the complexity of the procedure, but patients are generally advised to avoid strenuous activities during the initial recovery phase.
| Short Descr | REMOVAL OF URETER STONE | Medium Descr | URTROLITHOTOMY LOWER ONE-THIRD URETER | Long Descr | Ureterolithotomy; lower 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. | 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) |
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| 2011-01-01 | Changed | Medium description changed. |
| Pre-1990 | Added | Code added. |