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An open ureteroneocystostomy is a surgical procedure that involves the reattachment of the ureter to the bladder, specifically designed to address issues at the ureterovesical junction (UVJ). In this procedure, the distal segment of the ureter is carefully divided at or near the UVJ, which is the point where the ureter connects to the bladder. Following this, an incision is made in the dome of the bladder wall, extending down to the mucosal layer. A smaller incision is then created in the bladder mucosa to facilitate the connection with the ureter. The detached ureter segment is meticulously trimmed and its end is spatulated, which means it is shaped to create a wider surface area for the anastomosis. This full-thickness connection is established between the ureter and the bladder mucosa, ensuring a secure attachment. To prevent the backflow of urine, the bladder wall is closed over a 2-3 cm segment of the ureter, forming a tunnel that aids in maintaining the proper position of the ureter. The original opening at the UVJ is subsequently closed to complete the procedure. In some cases, a temporary ureteral stent may be inserted to maintain the patency of the ureter and promote healing during the recovery phase. This procedure is particularly indicated when extensive ureteral tailoring or reconstruction is necessary before the ureter can be implanted into the bladder.
© Copyright 2025 Coding Ahead. All rights reserved.
The procedure of ureteroneocystostomy with extensive ureteral tailoring is indicated for various conditions that affect the normal function of the ureter and bladder. These indications include:
The procedure involves several critical steps to ensure successful ureteral reattachment and function. The steps are as follows:
After the ureteroneocystostomy procedure, patients typically require monitoring for any complications such as infection or urinary leakage. Recovery may involve a hospital stay, during which the temporary ureteral stent is monitored for proper function. Patients are advised to follow up with their healthcare provider to assess the healing process and ensure that the ureter is functioning correctly. Pain management and hydration are also important aspects of post-operative care. The expected recovery time can vary based on individual circumstances and the complexity of the procedure performed.
| Short Descr | REIMPLANT URETER IN BLADDER | Medium Descr | URETERONEOCYSTOSTOMY W/URETERAL TAILORING | Long Descr | Ureteroneocystostomy; with extensive ureteral tailoring | 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) | 2 - Co-surgeons permitted and no documentation required if the two- specialty requirement is met. | 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 |
| 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. | 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. | 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.) | 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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| 1993-01-01 | Added | First appearance in code book in 1993. |