0T16079
Bypass Ureter, Right to Colocutaneous with Autologous Tissue Substitute, 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 | 7 Autologous Tissue Substitute |
| 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
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.
Device: Autologous Tissue Substitute
Autologous Tissue Substitute identifies a device value where material harvested from the patient's own body, such as an autograft, is used to replace or reconstruct a body part. Its defining feature is tissue origin from the patient, setting it apart from Nonautologous Tissue Substitute, sourced from a donor or animal, and Synthetic Substitute, made of manufactured material.
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.