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ABLATION
The cutting away or erosion of tissue
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Ablation Codes:
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
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Ablation Procedure:
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.
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CALCULUS:
Concretion of mineral salts, also called a stone
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Difference bet CALCULUS/CALCULI ...
- 1. Calculus: Singular
- 2. Calculi: Plural
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Procedure for the removal of Calculus:
Codes: 50060, 50065, 50070, 50075
- Nephrolithotomy: Kidney stone removal (Removal of calculus)
- Code: 50060
- Secondary surgical operation for calculus, 50065Procedures complicated by congenital kidney abnormality 50070Removal of a Staghorn calculus 50075
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STAGHORN Calculus:
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
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Lithotripsy:
Crushing of a gallbladder or urinary bladder stone followed by irrigation to wash the fragment out.
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CRYOSURGERY:
Destruction of lesions using extreme cold
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CRYOSURGICAL PROCEDURE:
is the use of a machine that applies subfreezing temp that is delivered 2 a lesion.
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Kidney Subheadings Report:
- 1. Exploration
- 2. Nephrostomy
- 3. Drainage
- 4. Nephrolithotomy
- 5. Pyelotomy
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RETROPERITONEAL:
- 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.
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NEPHROSTOMY:
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.
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NEPHROTOMY:
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)
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Nephrolithotomy:
- -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
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Extracorporeal Shock Wave Lithotripsy:
ESWL
- 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
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