UNIVERSITY OF MINNESOTA PHYSICIANS, DEPARTMENT OF UROLOGIC SURGERY

Document Sample
scope of work template
							                                                                      GENERAL UROLOGY
                              UNIVERSITY OF MINNESOTA PHYSICIANS, DEPARTMENT OF UROLOGIC SURGERY
                                         MMC 394 420 DELAWARE ST SE MINNEAPOLIS, MN 55455

__X___Dr Kyle Anderson (153841)                                    Date of Service____________________________________________________

                                                                   Patient __________________________________________________________
____441 UofM Inpt ___443 UofM Outpt
 ____445 Riverside Inpt ___448 Riverside Outpt                     MRN ____________________________________________________________

                                                                   Billing Area: Urology 660

MODIFIERS:
#22 Unusual Procedural Service                               #50 Bilateral Procedure                               #62 Two Surgeons

#26 Professional Component                                   #59 Distinct Procedural Service                       #80 Assistant Surgeon

                                                             #79 Unrelated Procedure Same Phys/PO                  #82 Assistant Surgeon (no resident



PCNL                                                                                                Cystoscopy/Ureteroscopy
___ 50394-injection procedure for pyelography through                                               ___50590 Lithotripsy/ESWL (9.64, 90)
     nephrostomy or pyelostomy tube or indwelling cath                                              ___52000 Cystourethroscopy-sep
___ 50395 for the introduction of the guide into the renal                                          ___52004 Cysto Bladder biopsy
     pelvis and or ureter with dilation to establish                                                ___52005 Cysto, ureteral cath, w/wo instillation of
     nephrostomy tract, percutaneous                                                                          contrast
___ 50080 Percutaneous w/wo dilation (15.61, 90)                                                    ___52310 Cysto, removal foreign body, simple (2.81, 0)
___ 50081 Over 2 cm (23.32, 90)                                                                     ___52315 Cysto, removal foreign body compl (5.2, 0)
                                                                                                    ___52344 Ureteroscopy treat uret strict (7.81, 0)
___ 74425 Urography, antegrade, (pyelostogram,                                                      ___52332 Cysto w/insertion indwelling stent (2.83, 0)
     nephrostogram, loopogram), radiological supervision                                            ___52351 Cysto ureteroscopy (5.85, 0)
     and interpretation                                                                             ___52352 Ureteroscopy w/manip of calc (6.87, 0)
                                                                                                    ___52353 Ureteroscopy w/ lithotripsy (7.96, 0)
___ 74485 Dilation of nephrostomy, ureters, or urethra                                              ___52354 Ureteroscopy w/biopsy fulguration (7.33, 0)
                                                                                                    ___52355 Ureteroscopy w/ resection of tumor (8.81, 0)
___ 50575 Antegrade/retrograde endopyelotomy (13.96, 0)
                                                                                                    ___ 74485 Modifier 26 Dilation of nephrostomy,
                                                                                                              ureters, or urethra (0.54, XX)



Laparoscopy                                                                                         Laparoscopy Continued
                                                                                                    ___ 50544 Pyeloplasty (34.83, 90)
___ 55866 Laparoscopic Prostatectomy (48.25, 90)                                                    ___ 50605 Ureterotomy for indwelling stent (25.42, 90)
___ 38770. Pelvic lymphadenectomy, including external
     iliac, hypogastric, and obturator nodes (separate                                              ___ 50542 Cryoablation renal tumor (32.23, 90)
     procedure) (21.61, 90)                                                                         ___ 50543 Partial nephrectomy (41.14, 90)
                                                                                                    ___ 50545 Nephrectomy (37.31, 90)
___ 60650 Adrenalectomy (20.63, 90)
                                                                                                    ___ 50548 Nephroureterectomy (37.64, 90)
___ 44180 Laparoscopy, surgical, enterolysis (freeing of
     intestinal adhesion) (15.19, 90)                                                               ___ 76998 Modifier 26 US guidance

___ 51595 Cystectomy c conduit or neobladder, LN                                                    ROBOT
     dissection                                                                                     ___S2900 Robotic surgery
___ 50605 Stent placement via ureterotomy

ICD 9 Codes
185 Prostate Cancer                         562.1 Diverticulitis                                                      Open Surgery
                                                                                                                      ___50240 Open Partial Nephrectomy
189 Kidney cancer                           599.70 (hematuria, unspecified);                                          (36.37, 90)
189.1 Tumor of renal pelvis                 599.71 (gross hematuria); or
593.9 Kidney Mass                           599.72 (microscopic hematuria).                                           TURBT
                                                                                                                      ___52234 Small 0.5-2cm (6.91, 0)
                                                                                                                      ___52235 Medium 2-5 cm (8.12, 0)
592 Calculus kidney                                                                                                   ___52234 Large >5cm (14.22, 0)
592.1 Ureteral Calculus
                                                                                                                      PERCUTANEOUS
593.2 Cyst kidney, acquired                                                                                           ___50593 Percutaneous renal cryotherapy
753.1 Congenital kidney cyst
                                                                                                                      ___ 55700 Prostate biopsy
593.3 Stricture ureter                                                                                                ___ 76872 US of prostate
593.4 Other ureteric obstruction                                                                                      ___ 76942 US guidance for biopsy

						
Related docs