Neobladder Formation Procedure

Per 3Q 2024 Coding Clinic: 

Code Example

 A neobladder is formed using intestine that is still connected to its original vascular supply:

A patient underwent laparoscopic radical cystectomy, along with formation of an orthotopic neobladder. During surgery, a 55 cm segment of small bowel was selected to form the neobladder. The bowel was divided at both proximal and distal aspects of the neobladder, and the mesentery was incised with care to preserve blood supply to the neobladder. The segment of small intestine was placed towards the pelvis and a side-to-side enteroenteric bowel anastomosis was done. The ureters were then anastomosed to the butt end of the chimney and ureteral stents were placed prior to closure of the anastomosis. The neobladder-urethral anastomosis was completed. The leading edge was brought easily down into the pelvis and anastomosed to the posterior edge of the remaining urethra. The neobladder was then sutured in a modified Studer neobladder fashion.

Code Assignment

ICD-10-PCS code 0DX84ZB:

Transfer small intestine to bladder, percutaneous endoscopic approach for the ‘neobladder formation’. The root operation Transfer is appropriate for this surgery because a new bladder was formed using intestinal tissue still attached to its vascular supply. Transfer is defined as moving, without taking out, all or a portion of a body part to another location to take over the function of all or a portion of a body part.

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