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convert from partial nephrectomy to open radical nephrectomy.

Nancy Posted Wed 17th of February, 2016 11:29:46 AM

The patient was taken to the operating room today for attempt at right robotic partial nephrectomy which was converted to right robotic radical nephrectomy. The tumor was quite deep and there was significant hydronephrosis which made reconstruction of the kidney and possible after removal of the tumor. The right kidney was removed completely.
So I looked at past urology coding publications and found it should be coded 50543-52,50230 with modifier XS but cannot find the ICD-10 code for conversion V64.41. ICD-10-CM does not include an equivalent to this diagnosis code. Am I coding this correctly?

SuperCoder Answered Thu 18th of February, 2016 05:01:03 AM

Code V64.41 is used when laparoscopic surgical procedure converted to open procedure.
Whereas in this scenario, there is no conversion of laparoscopic surgical procedure to open procedure. Both procedures are laparoscopic only.
Appropriate procedure codes would be:
50545 Laparoscopy, surgical; radical nephrectomy (includes removal of Gerota's fascia and surrounding fatty tissue, removal of regional lymph nodes, and adrenalectomy)
50543-52-XU Laparoscopy, surgical; partial nephrectomy
S2900 Surgical techniques requiring use of robotic surgical system

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