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The CPT® Code 50815 refers to the surgical procedure known as ureterocolon conduit, which involves the creation of a urinary diversion using a segment of the colon. This procedure is typically indicated for patients suffering from various conditions that impair normal bladder function, such as bladder cancer, neurogenic bladder, radiation injury to the bladder, and intractable incontinence. The ureterocolon conduit serves as an alternative pathway for urine to exit the body when the bladder is unable to perform its function effectively. During the procedure, the abdomen is incised in the midline, allowing access to the peritoneal cavity. The small bowel is then isolated and temporarily moved out of the surgical field to provide a clear view of the ureters, which are subsequently mobilized and divided near the ureterovesical junction. The selected segment of the colon is prepared for use as the conduit, and the remaining bowel segments are reconnected to restore continuity. A stoma is created through the abdominal wall, allowing urine to be collected externally. The ureters are then anastomosed to the conduit, ensuring proper drainage of urine. This procedure is critical for patients who require a reliable method of urine diversion due to underlying medical conditions affecting the bladder.
© Copyright 2025 Coding Ahead. All rights reserved.
The ureterocolon conduit procedure is indicated for patients with specific medical conditions that necessitate urinary diversion. These indications include:
The ureterocolon conduit procedure involves several critical steps to ensure successful urinary diversion. The process begins with an incision in the midline of the abdomen, followed by the opening of the peritoneum to gain access to the internal organs. The small bowel is then isolated and temporarily packed out of the surgical field to provide a clear view of the ureters. Once the ureters are exposed, they are mobilized and divided distally near the ureterovesical junction, with the ureteral stumps being ligated to prevent any leakage. The surgeon then identifies and isolates the segment of colon or ileum that will be used for the conduit. After this, the remaining bowel segments, both distal and proximal to the isolated segment, are anastomosed to restore bowel continuity. Next, a stoma site is selected on the abdominal wall, and the skin is incised to facilitate the creation of the stoma. The dissection continues down to the anterior rectus fascia, which is also incised, allowing access to the rectus muscle. The rectus muscle is divided using blunt dissection to create a pathway for the conduit. The distal end of the conduit is then pulled through the abdominal wall, everted, and sutured to the skin or subcutaneous tissues to secure the stoma in place. The proximal end of the conduit is closed with sutures to prevent any backflow of urine. A tunnel is created from the conduit to the ureters, allowing for the ureters to be pulled through this tunnel and connected to the conduit. The ends of the ureters are spatulated to facilitate a better anastomosis. Stents are placed in both ureters to ensure proper drainage during the healing process. Small incisions are made in the conduit, and the ureters are anastomosed to the conduit approximately 3 cm apart to maintain adequate spacing. Finally, drains are placed as needed to manage any postoperative fluid accumulation, and the surgical incisions are closed in layers to promote healing. An ostomy bag is then placed over the ostomy site to collect urine, completing the procedure.
After the ureterocolon conduit procedure, patients will require careful monitoring and management to ensure proper recovery. Post-operative care typically includes monitoring for any signs of infection, ensuring that the stoma is functioning correctly, and managing any pain or discomfort. Patients may need to be educated on how to care for the stoma and use the ostomy bag effectively. Follow-up appointments will be necessary to assess the healing process and the function of the conduit. Additionally, patients may require adjustments in their diet or fluid intake to accommodate the changes in urinary function. Overall, the post-procedure phase is crucial for ensuring the long-term success of the urinary diversion and the patient's overall well-being.
| Short Descr | URINE SHUNT TO INTESTINE | Medium Descr | URETEROCOLON CONDUIT INTESTINE ANASTOMOSIS | Long Descr | Ureterocolon conduit, including intestine anastomosis | 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 |
| 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. | 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). | 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.) | 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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| 2002-01-01 | Changed | Code description changed. |
| Pre-1990 | Added | Code added. |