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The procedure described by CPT® Code 50860 refers to a ureterostomy, specifically the transplantation of the ureter to the skin. This surgical intervention is typically indicated when there is a need to divert urine away from the bladder, often due to conditions affecting the urinary tract. In this procedure, a cutaneous ureterostomy is performed, which involves creating an artificial opening on the abdominal surface to allow urine to exit the body directly from the ureter. The process begins with a lateral incision in the abdomen, where the surgeon carefully divides the overlying muscle and retracts the peritoneum to gain access to the ureter. The ureter is then divided as close to the ureterovesical junction (UVJ) as possible, ensuring that the distal stump is ligated to prevent urine leakage. The proximal ureter is meticulously dissected free from surrounding tissues and brought into the surgical wound. A catheter is introduced through the ureter into the renal pelvis to facilitate kidney drainage, which may be secured to the abdominal wall. Alternatively, a stoma is created, allowing the ureter to be sutured to the abdominal surface, thus diverting urine from the bladder. To complete the procedure, a drain is placed in the abdominal wound, and the incision is closed around this drain to promote healing and prevent fluid accumulation.
© Copyright 2025 Coding Ahead. All rights reserved.
The procedure described by CPT® Code 50860 is indicated for various conditions that necessitate the diversion of urine from the bladder. These indications may include:
The procedure for a ureterostomy, as outlined in CPT® Code 50860, involves several critical steps to ensure successful diversion of urine. The first step is to make a lateral incision in the abdomen, which allows access to the underlying structures. Following the incision, the surgeon carefully divides the overlying muscle to reach the peritoneum, which is then retracted to expose the ureter. The ureter is divided as close to the ureterovesical junction (UVJ) as possible, ensuring that the distal stump is ligated to prevent any leakage of urine. Next, the proximal ureter is meticulously dissected free from the surrounding tissue, allowing it to be brought up into the surgical wound. To facilitate drainage from the kidney, a catheter is passed through the ureter into the renal pelvis. This catheter may be left in place and secured to the abdominal wall to maintain proper drainage. Alternatively, the surgeon may create an artificial opening, or stoma, on the surface of the abdomen. In this case, the ureter is sutured to the stoma, effectively diverting the passage of urine from the bladder to the outside of the body. Finally, a drain is inserted into the abdominal wound to prevent fluid accumulation, and the wound is closed around the drain to promote healing.
After the ureterostomy procedure, patients typically require careful monitoring and management to ensure proper recovery. Post-procedure care may include monitoring for signs of infection at the surgical site, managing pain, and ensuring that the urinary drainage is functioning as intended. Patients may need to be educated on stoma care if a stoma has been created, including how to clean the area and manage any appliances required for urine collection. Follow-up appointments are essential to assess the healing process and to address any complications that may arise, such as blockages or infections. Additionally, patients may require adjustments in their fluid intake and dietary habits to accommodate the changes in urinary function.
| Short Descr | TRANSPLANT URETER TO SKIN | Medium Descr | URETEROSTOMY TRANSPLANTATION URETER SKIN | Long Descr | Ureterostomy, transplantation of ureter to skin | 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. | 79 | Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, 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). | AQ | Physician providing a service in an unlisted health professional shortage area (hpsa) | 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) | 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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| Pre-1990 | Added | Code added. |