© Copyright 2025 American Medical Association. All rights reserved.
A continent urinary diversion procedure, as described by CPT® Code 50825, involves the surgical creation of a new pathway for urine to exit the body while allowing the patient to maintain some control over urination. This procedure is distinct from other forms of urinary diversion because it enables the patient to void through the urethra normally or through a stoma that incorporates a valve mechanism. The valve mechanism is designed to prevent urine leakage, allowing the patient to manage their urinary output by catheterizing the pouch at regular intervals. The surgical approach typically involves a midline incision in the abdomen, through which the small bowel is isolated and temporarily moved out of the surgical field. The ureters, which carry urine from the kidneys to the bladder, are carefully exposed, mobilized, and divided near their junction with the bladder. The procedure includes the ligation of the ureteral stumps and the selection of a segment of small or large intestine, usually measuring 30-35 cm, to construct the urinary pouch. This segment is meticulously isolated while preserving its blood supply, and the remaining portions of the intestine are reconnected to restore bowel continuity. The isolated intestinal segment is then shaped into a pouch, which may involve detubularization and the creation of a tunnel for the ureters to connect to the pouch. Depending on the patient's anatomy and needs, the pouch may be anastomosed to the bladder neck in females or the proximal urethra in males, or a stoma may be created. If a stoma is formed, a valve mechanism is constructed to facilitate urine retention and controlled release. Throughout the procedure, careful attention is paid to the surgical technique to ensure proper function and minimize complications.
© Copyright 2025 Coding Ahead. All rights reserved.
The continent urinary diversion procedure (CPT® Code 50825) is indicated for patients who require a surgical solution for urinary diversion due to various medical conditions. These indications may include:
The procedure for creating a continent urinary diversion involves several detailed steps, which are as follows:
After the continent urinary diversion procedure, patients typically require monitoring for complications such as infection, leakage, or obstruction. Post-operative care may include pain management, wound care, and instructions on catheterization techniques for urine management. Patients are often advised on dietary modifications and hydration to support recovery. Follow-up appointments are essential to assess the function of the urinary pouch and ensure that the patient is adapting well to the new urinary diversion method. Education on potential complications and signs to watch for is also provided to ensure patient safety and effective management of their condition.
| Short Descr | CONSTRUCT BOWEL BLADDER | Medium Descr | CONTINENT DVRJ W/INT ANAST ANY SGM SM&/LG INTSTN | Long Descr | Continent diversion, including intestine anastomosis using any segment of small and/or large intestine (Kock pouch or Camey enterocystoplasty) | 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) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | 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. | 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). | 52 | Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well-being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use). | 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. | 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 | 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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| 2013-01-01 | Changed | Medium Descriptor changed. |
| 2002-01-01 | Changed | Code description changed. |
| Pre-1990 | Added | Code added. |