0T160ZB
Bypass Ureter, Right to Bladder 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 | 6 Ureter, Right |
| Approach | 0 Open |
| Device | Z No Device |
| Qualifier | B Bladder |
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
Ureter, Right
The right ureter is the muscular tube carrying urine from the kidney pelvis to the bladder, and bypass becomes necessary when a segment is irreparably obstructed or destroyed by stricture, tumor invasion, or extensive fibrosis from prior surgery or radiation, such that the natural channel can no longer be restored by simple repair. The procedure creates an alternate route for urine, which may involve connecting healthy ureter above the defect to the bladder, bowel segment, or skin, bypassing the diseased length rather than excising it. On the right, the ureter's course near the appendix, cecum, and iliac vessels can influence which alternate pathway is feasible. Because the ureter is a tubular structure, coding depends heavily on identifying the specific conduit used to reroute flow around the obstruction.
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: Bladder
Bladder functions as a qualifier indicating the urinary bladder as the secondary site in procedures like fistula repair or bypass originating from another organ. It pinpoints that the connection or diversion involves the bladder specifically, distinguishing it from neighboring qualifiers such as Ureter or Vagina that denote different pelvic endpoints.
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.