Urinary & Male Genital Systems

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Urinary & Male Genital Systems
2010-11-09 14:11:03
Urinary Male Genital

Terms, Codes, & Procedures
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    The cutting away or erosion of tissue
  2. 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
  3. 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.
    Concretion of mineral salts, also called a stone
  5. Difference bet CALCULUS/CALCULI ...
    • 1. Calculus: Singular
    • 2. Calculi: Plural
  6. 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, 50065
    • Procedures complicated by congenital kidney abnormality 50070
    • Removal of a Staghorn calculus 50075
  7. 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
  8. Lithotripsy:
    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.
  11. Kidney Subheadings Report:
    • 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)
  15. 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
  16. Extracorporeal Shock Wave Lithotripsy:
    • 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