CPT Code 50220: Overview

Code: 50220
Description: Nephrectomy, including partial ureterectomy, any open approach including rib resection
Context: This code is used for a surgical procedure involving the removal of a kidney (nephrectomy). It may also include the partial removal of the ureter and, if necessary, a rib resection. This open surgical approach is used for various conditions, including kidney cancer, severe kidney damage, or other renal diseases.

Guidelines for Proper Use

• Specific Use for Open Nephrectomy: Apply 50220 for open surgical procedures that involve the removal of a kidney. This includes cases where part of the ureter and possibly a rib are also removed.
• Documentation of Surgical Procedure: Ensure healthcare providers’ documentation includes detailed information about the nephrectomy, such as the indication for surgery, the extent of the procedure, and any additional structures removed (e.g., part of the ureter, rib).
• Inclusion of Associated Procedures: The code encompasses the nephrectomy procedure along with partial ureterectomy and rib resection if these are performed as part of the kidney removal surgery.
• Exclusion of Other Surgical Approaches: Do not use 50220 for nephrectomies performed via laparoscopic or other minimally invasive approaches. There are specific codes for these types of procedures.
• Compliance with Surgical Protocols: Use 50220 in accordance with standard surgical guidelines and protocols for nephrectomy, as well as payer-specific rules.

Common Misuses of 50220

• Using for Laparoscopic Nephrectomy: Misuse occurs if 50220 is applied to nephrectomies performed using laparoscopic techniques. This code is specifically for open surgical approaches.
• Incomplete Documentation of Procedure Details: Not providing comprehensive details about the open approach or the structures removed during the nephrectomy can lead to misuse of this code.
• Bundling with Unrelated Procedures: If additional, unrelated surgical procedures are performed during the same session, they should be billed separately and not included under 50220.