SURGICAL PROCEDURES OPERATIONS ON THE UROGENITAL SYSTEM

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1 KIDNEYS AND PERINEPHRUM 1. No additional claim should be made for nephroscopy when done at the time of pyelolithotomy or nephrolithotomy. 2. In a routine surgical approach to the kidney and related procedures, no additional claim should be made for rib resection carried out for access purposes. 3. When an adrenalectomy is performed in conjunction with a nephrectomy and is incidental to the removal of the kidney, there should be no additional claim for the adrenalectomy. Percutaneous Procedures (IOP) Percutaneous nephrostomy Insertion of stent Dilation of tract Selective catheterization of calyces Nephroscopy Removal of renal calculi if disintegrated by ultrasound...add Renal biopsy, needle (IOP) Drainage of kidney abscess Drainage of perinephric abscess Exploration of renal and perirenal tissues with or without biopsy or unroofing of cyst Nephrotomy with drainage - nephrostomy with removal of calculus Transection of aberrant renal vessels Pyelotomy - with drainage with removal of calculus with diversion of urine Calycectomy with diversion of urine Hemi-nephrectomy Partial or hemi-nephrectomy with total ureterectomy Nephrectomy simple thoraco-abdominal or radical nephrectomy with or without gland dissection partial nephrectomy for malignancy Nephro-ureterectomy, total, without resection of ureterovesical junction Nephro-ureterectomy, total, with resection of ureterovesical junction of stenosed renal artery with reimplantation or homograft R-1

2 KIDNEYS AND PERINEPHRUM (Cont d) Pyeloplasty Nephropexy Renal sympathectomy Symphysiotomy, for horseshoe kidney with or without nephropexy and associated procedures Ruptured or lacerated kidney - repair or removal Litholapaxy Staghorn (pelvic) with lithotripsy under x-ray control Extra Renal Procedures of retroperitoneal tumour Exploration of retroperitoneal tumour Sacro-coccygeal teratoma Renal hypothermia - extra Extracorporeal Shock Wave Lithotripsy (IOP) unilateral, any mode, per session, per patient bilateral, any mode, per session, per patient Kidney Transplants Kidney transplant (team fees, these fees do not include immunosuppressive therapy, which is on a fee-forservice basis Donor nephrectomy (extra) team fee, uni or bilateral Renal autotransplantation R-2

3 URETER Peri-ureteral abscess Ureterotomy, abdominal or vaginal exploratory or for drainage upper 2/ lower 1/ with removal of calculus upper 2/ lower 1/ where ureter has been previously opened upper 2/ lower 1/ Ureterectomy including ureterovesical junction other Trimming of ureter Uretero-vesical anastomosis or reimplantation - unilateral Bifid ureter Uretero-ileal conduit Uretero-ileal conduit with total cystectomy Uretero-ileal conduit with ureterectomy and ileal replacement Uretero-intestinal anastomosis or transplant - unilateral Uretero-ureterostomy Ureterostomy, cutaneous, unilateral Uretero-vaginal fistula Ureterolysis for periureteral fibrosis - unilateral Ureteroplasty (Hutch), unilateral Bladder flap (Baori) Spontaneous/traumatic rupture or transection immediate - upper 2/ lower 1/ late repair - upper 2/ lower 1/ Endoscopic Procedures Calibration and/or dilation - 1 or both sides Manipulation and/or removal of calculus including ureteral meatotomy if required Cystoscopy and diagnostic ureteroscopy above Intramural ureter (IOP) with removal of calculus...add if disintegrated by ultrasound...add R-3

4 BLADDER Endoscopy-Cystoscopy Diagnostic Procedures, includes dilation for access (IOP) Note: Includes catheterization of ureters with or without collection or ureteral specimens, intravenous function test and retrograde injection of opaque media and/or manometry and/or meatotomy Cystoscopy with or without urethroscopy Repeat within 30 days With transurethral biopsy, brush biopsy of renal pelvis and/or ureter and/or insertion of ureteral stent... add With retrograde pyelogram... add With needle biopsy of prostate... add Therapeutic Procedures (payable with, add-on to code 97070) With electrocoagulation of tumour... add With electrocoagulation of ulcer... add With excision of tumour or tumours including base and adjacent muscles and electrocoagulation if necessary single tumour 1-2 cm. diameter... add single tumour over 2 cm. diameter... add multiple tumours... add With resection bladder neck - female... add male... add With electro-surgical ureteral meatotomy... add With removal of foreign body or calculus... add Introduction (IOP) Catheterization office home hospital... VF VF Intravesicular chemotherapy Aspiration (IOP) Cystotomy with trochar or cannula and insertion of tube al cystotomy or cystostomy al cystotomy or cystostomy and electrocoagulation of tumour Cystolithotomy Cutaneous vesicostomy Reduction cystoplasty (bladder plication) R-4

5 BLADDER (Cont d) Cystectomy Partial for tumour or diverticulum (single or multiple) with reimplantation of ureter with reimplantation of ureters Complete cystectomy, without transplant with uretero-ileal conduit Complete cystectomy with Koch pouch urinary diversion of urachal cyst or sinus with or without umbilical hernia repair of urachus, repair of bladder and diversion of urine Extrophy excision of bladder and repair of abdominal wall, inclusive of graft plastic repair of extrophy using bladder and including skin flaps Urinary diversion procedure using intestine, without cystectomy of ruptured bladder Cystoplasty, using intestine Suprapubic sphincterectomy for Marion s disease Plastic repair of bladder neck child adult or adolescent with diverticulectomy Destruction Litholapaxy, visual or tactile and removal of fragments Closure of fistula External, suprapubic Vesico-vaginal - vaginal approach trans-vesical approach Vesico-rectal or vesicosigmoid R-5

6 URETHRA Biopsy of urethra without endoscopy (IOP) Urethrotomy, external Urethrostomy Meatotomy and plastic repair Peri-urethral abscess - complete care Caruncle Urethral papilloma, single or multiple Stricture, including diversion stage stage - first stage second stage Diverticulectomy - male or female Posterior urethral valve Prolapse urethra, excision Urethrectomy - radical Endoscopy Urethroscopy - diagnostic (IOP) with biopsy (IOP) Internal urethrotomy Removal of foreign body or calculus Urethral sling Marshall Marchetti Insertion of artificial urinary sphincter Urethroplasty - 1 st stage posterior anterior nd stage One stage repair (to include skin graft if necessary) Kauffman type procedures for urinary incontinence where perineum has been previously operated on for incontinence removal of perineal incontinence prosthesis Rupture, anterior urethra (diversion of urine, extra) Posterior urethra - immediate repair late repair Fistula penile urethra (diversion of urine, extra) perineal urethra recto-urethral with diversion, colostomy and closure of colostomy R-6

7 URETHRA (Cont d) Destruction Urethro-vesicolysis Transurethral incision or resection of external sphincter (when sole operative procedure) Manipulation (IOP) Dilation of stricture, male local anaesthetic general anaesthetic Dilation of urethra, female general anaesthetic R-7