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Laparoscopy, surgical ureterolithotomy, is a minimally invasive surgical procedure aimed at the removal of a ureteral stone, also known as a calculus, from the ureter. This procedure is particularly beneficial for patients suffering from ureteral obstruction caused by stones, which can lead to significant pain and potential complications if left untreated. The laparoscopic approach offers several advantages over traditional open surgery, including reduced postoperative pain, shorter recovery times, and minimal scarring. The procedure can be performed using either a retroperitoneal or transperitoneal approach, depending on the location of the stone within the ureter. In the retroperitoneal approach, the surgeon makes incisions strategically placed to access the ureter while minimizing disruption to surrounding tissues. This technique involves careful dissection to separate the peritoneum from the abdominal wall, allowing for the introduction of a laparoscope and surgical instruments. The identification and removal of the stone are performed with precision, utilizing forceps to grasp the ureter and extract the stone effectively. Post-procedure, the ureter may be stented to ensure proper healing and function. Overall, laparoscopic ureterolithotomy is a critical procedure in urology that addresses ureteral stones with enhanced safety and efficacy.
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The laparoscopic ureterolithotomy procedure is indicated for patients presenting with the following conditions:
The laparoscopic ureterolithotomy procedure involves several key steps to ensure the successful removal of the ureteral stone:
After the laparoscopic ureterolithotomy, patients are typically monitored for any immediate complications. Post-procedure care may include pain management, hydration, and monitoring for signs of infection or complications. Patients may be advised to follow up with their healthcare provider to assess recovery and the need for stent removal if a stent was placed. The expected recovery time is generally shorter compared to open surgery, allowing patients to return to normal activities more quickly, although individual recovery may vary based on overall health and the complexity of the procedure.
| Short Descr | LAPAROSCOPY URETEROLITHOTOMY | Medium Descr | LAPAROSCOPY URTROLITHOTOMY | Long Descr | Laparoscopy, surgical; ureterolithotomy | 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 | Hospital Part B services paid through a comprehensive APC | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P5E - Ambulatory procedures - other | MUE | 1 | CCS Clinical Classification | 112 - Other OR therapeutic procedures of urinary tract |
This is a primary code that can be used with these additional add-on codes.
| 49327 | Addon Code MPFS Status: Active Code APC N ASC N1 Laparoscopy, surgical; with placement of interstitial device(s) for radiation therapy guidance (eg, fiducial markers, dosimeter), intra-abdominal, intrapelvic, and/or retroperitoneum, including imaging guidance, if performed, single or multiple (List separately in addition to code for primary procedure) |
| 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). | 58 | Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78. | 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. | 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) | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure |
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| 2001-01-01 | Changed | Code description changed. |
| 2000-01-01 | Added | First appearance in code book in 2000. |
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