0T130Z9
Bypass Kidney Pelvis, Right to Colocutaneous with No Device, Open Approach
Procedural Specifications
| Clinical Axis | Detail Definition |
|---|---|
| Section | 0 Medical and Surgical |
| Body System | T Urinary System |
| Operation | 1 Bypass |
| Body Part | 3 Kidney Pelvis, Right |
| Approach | 0 Open |
| Device | Z No Device |
| Qualifier | 9 Colocutaneous |
Operation Definition
Altering the route of passage of the contents of a tubular body part
Procedure Overview
Bypass procedures in the urinary system reroute the flow of urine around a damaged, obstructed, or diseased segment so it can drain through a new path instead. Common examples include an ileal conduit or continent urinary diversion after bladder removal, a ureteroneocystostomy that reconnects a ureter to the bladder at a new site, or a yeloureteral bypass for a blocked ureteropelvic junction. These operations are performed when a tumor, stricture, chronic obstruction, or a failed bladder makes normal drainage unsafe, since backed-up urine can damage the kidneys or cause repeated infections.
Patients typically encounter these procedures alongside cancer treatment, after trauma, or when a congenital narrowing has caused progressive kidney damage. The new pathway may be temporary, to protect a healing repair, or permanent, when the original structure cannot be salvaged.
Anatomy & Axis Detail
Kidney Pelvis, Right
The right kidney pelvis is the funnel-shaped collecting chamber where the major calyces converge before urine passes into the ureter, and it is the segment most often bypassed when chronic ureteropelvic junction obstruction, extensive scarring, or a tumor blocks normal outflow despite an otherwise functioning kidney. A bypass procedure here reroutes urine around the diseased junction, typically by anastomosing the pelvis to a healthier downstream conduit or diverting it externally, preserving renal function that would otherwise deteriorate from sustained back-pressure. Because the pelvis lies deep within the renal sinus, the approach must account for surrounding vasculature and the risk of recurrent stricture at the new connection. Laterality matters for documentation, as the right kidney's proximity to the liver and duodenum can influence surgical approach compared to the left side.
Approach: Open
Open approach means the surgeon cuts through skin, mucous membrane, or other tissue layers to physically expose the target site to view before performing the procedure. It gives direct visualization and hands-on access, distinguishing it from Percutaneous approaches where instruments pass through a small puncture without exposing the site. Open is typical for procedures needing wide access, such as most laparotomies.
Qualifier: Colocutaneous
Colocutaneous describes a bypass that creates a connection between the colon and the skin surface, effectively establishing an external opening such as a colostomy-type diversion. It is chosen when intestinal contents are rerouted to exit the body externally rather than into another internal structure. This contrasts with the plain Colon qualifier, which denotes an internal colon-to-colon or colon-to-organ route.
Coding & Documentation
Coders assign Bypass when documentation confirms a new route was created "from" one urinary structure "to" another (or to the skin, as in a conduit), rather than a repair of the existing channel. The operative note must name both the bypass origin and the qualifier destination, since the seventh-character qualifier changes with the target (bladder, ileum, cutaneous, etc.). A frequent error is coding Bypass when the surgeon actually performed Repair or Dilation of an existing passage rather than constructing an alternate route; another is missing the correct device value when a stent or conduit segment is left in place.