ICD-10-PCS Billable Code

0TM60ZZ

Reattachment Ureter, Right to No Qualifier with No Device, Open Approach

Procedural Specifications

Clinical Axis Detail Definition
Section0 Medical and Surgical
Body SystemT Urinary System
OperationM Reattachment
Body Part6 Ureter, Right
Approach0 Open
DeviceZ No Device
QualifierZ No Qualifier

Operation Definition

Putting back in or on all or a portion of a separated body part to its normal location or other suitable location

Procedure Overview

Reattachment procedures restore a urinary structure that has been separated from the body, or from its normal position, back to where it belongs. In practice this most often means reimplanting a ureter that was cut during trauma or surgery back onto the bladder, or reconnecting a kidney's blood supply and ureter during a transplant. The goal is to reestablish the normal anatomic path so urine can drain as it did before the structure was detached.

This is a distinct and less commonly performed procedure than repair, since it specifically addresses a body part that was physically severed, whether by injury, by surgical necessity, or as part of a planned transplant, rather than one that is damaged but still attached.

Anatomy & Axis Detail

Ureter, Right

The right ureter transports urine from the right kidney to the bladder along a course that crosses the iliac vessels and runs near the appendix and cecum, and reattachment describes surgically rejoining a completely transected ureter back to its native connection, whether at the renal pelvis, mid-ureter, or bladder end. This is required after iatrogenic transection during pelvic or colorectal surgery, penetrating trauma, or as part of bench reconstruction with reimplantation. Because ureteral tissue has a limited blood supply, reattachment relies on meticulous, tension-free approximation, often over an internal stent, to prevent stricture or leakage at the repair site, and the right-sided designation reflects the distinct regional anatomy and surgical exposure involved compared with the left ureter.

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.

Coding & Documentation

For a code from this family, documentation must show that a body part was completely detached and then physically reconnected, such as a ureter transected during pelvic surgery and reimplanted into the bladder wall. The note should specify which structure was reattached and to what location, since reattachment to the original site versus a new location can affect code selection.

A frequent coding error is applying Reattachment to a ureteral reimplantation performed for reasons other than traumatic or surgical separation, such as a planned ureteroneocystostomy done to bypass a diseased ureteral segment; if the ureter was never fully detached, Reattachment does not apply and Repair or a different root operation is more accurate. Coders should also verify that vascular reattachment during a kidney transplant is captured with the appropriate body part and qualifier reflecting the transplant context.

Commonly Confused With

RepairReattachment is easily confused with Repair, which fixes an abnormality in a body part that remains connected to the body, and with Transplantation, which places a whole new organ from a donor.
TransplantationThe distinction from Transplantation is that Reattachment reconnects the patient's own previously detached tissue, not a donor organ, even though a transplant operation may include a reattachment step for connecting vessels.