Urinary & Male Genital Systems

The cutting away or erosion of tissue

Code 50250: Reports ablation of a kidney lesion by means of "cryosurgery(use of subfreezing temps)" & is performed w/ultrasonic guidance. If U/G is used it's "not reported separtely" as it's stated in the code description.

• Code 50593: If performed Percutaneously
• Code 50542: If performed w/use of a Laparoscope

The kidney is accessed through an incision in which a cryosurgical probe is inserted into the lesion. A cryosurgical machine is used & subfreezing temp is delivered 2 the lesion. Usually, more than 2 cycles R applied 2 ensure lesion is ablated.

Concretion of mineral salts, also called a stone

• 1. Calculus: Singular
• 2. Calculi: Plural

• Nephrolithotomy: Kidney stone removal (Removal of calculus)
• Code: 50060

• Secondary surgical operation for calculus, 50065
• Procedures complicated by congenital kidney abnormality 50070
• Removal of a Staghorn calculus 50075

is shaped like a deer antler & can become large & create extensive obstruction. If the calculus involves the renal pelvis & @ least 2 calyces, it's classified as a Staghorn Calculi.

• 1. 30% of stones R usually assoc. w/Urinary Infections
• 2. A nephrolithotomy may be performed after ESWL, which fragments the stones

Crushing of a gallbladder or urinary bladder stone followed by irrigation to wash the fragment out.

Destruction of lesions using extreme cold

is the use of a machine that applies subfreezing temp that is delivered 2 a lesion.

• 1. Exploration
• 2. Nephrostomy
• 3. Drainage
• 4. Nephrolithotomy
• 5. Pyelotomy

• Refers to the area located behind the peritoneum that is located in the abdominal cavity.
• The retroperitoneal space may be accessed by means of an abdominal incision.

Procedure used to decompress the renal system by means of the insertion of a catheter into the kidnye while leaving the other end of the catheter outside the body to temporarily drain the kidney.

• - The renal collecting system may be constructed by calculus or a defect of the renal pelvis or ureter.
• Code 50040: reports incisional placement of a draingage tube that involves incision into the renal pelvis (pyelotomy)
• Procedure: physician inserts a catheter into the kidney w/the other end carried to the skin surface & sutured in place on the flank.

is an exploration(only) of the inside of the kidney

- During this exploration 50045 no definititve procedure is performed

• -If however a "procedure is performed" the EXPLORATION is bundled into the "Definitive" procedure
• EX:
• if a surgeon begins an exploration procedure to determine the cause urinary obstruction & identified a "renal calculus" & removed the calculus, the procedure is No Longer an Exploration!!!...the procedure would now be Nephrolithotomy 50060
• - Also; the surgeon may perform a Renal Endoscopy @ the same time as the Nephrotomy (2 place stents or perform some other type of repair procedure)
• -the Endoscopy is reported "seperately" 50570-50580 (Endoscopy, kidney)

• -procedures incl removal of calculus 50060
• -Secondary surgical operation for calculus 50065
• -Procedures complicated by congentital kidney abnormality 50070
• -Removal of a staghorn calculus 50075

• If calculus involves the renal pelvis & @ least 2 calyces, it's classified as a Staghorn Calculi
• -Staghorn Calculus: is shaped like a deer antler & can become large & create extensive obsgtruction.
• -W/a Staghorn, a Nephroloithotomy may be performed after Extracorporeal Shock Wave Lithotripsy{ESWL}, which fragments the stones

• is used 2 B performed w/a machine in which the pt was submerged in fluid.
• * The newer machines don't require submersion; the pt is now placed on an x/ray table, & and a water filled cushion is placed under the pt's bk
• * This procedure is performed under general anesthesia in an operating room w/a built in ESWL machine.
• *Shock Waves are targeted to the stones by means of z/ray & pulverize the stones w/repeated shocks.
• *Particles susbsequently pass through the urinary tract