0TS84ZZ
Reposition Ureters, Bilateral to No Qualifier with No Device, Percutaneous Endoscopic Approach
Procedural Specifications
| Clinical Axis | Detail Definition |
|---|---|
| Section | 0 Medical and Surgical |
| Body System | T Urinary System |
| Operation | S Reposition |
| Body Part | 8 Ureters, Bilateral |
| Approach | 4 Percutaneous Endoscopic |
| Device | Z No Device |
| Qualifier | Z No Qualifier |
Operation Definition
Moving to its normal location, or other suitable location, all or a portion of a body part
Procedure Overview
Reposition procedures move a urinary structure to its normal location or to another suitable position when it has become displaced or malformed. A well-known example is correcting a horseshoe kidney or a kidney that has dropped from its normal position, and pyeloplasty performed to relocate and reshape the ureteropelvic junction so urine can drain properly.
These procedures address problems that are fundamentally about location or orientation rather than tissue damage - a kidney sitting too low, a ureter that takes an abnormal course, or a congenital anomaly discovered in childhood or found incidentally in an adult. Surgeons free the structure from surrounding attachments and fix it in its corrected position, sometimes with permanent sutures or mesh.
Because the underlying tissue is retained and simply relocated, Reposition differs from procedures that remove, replace, or reinforce urinary tissue.
Anatomy & Axis Detail
Ureters, Bilateral
This value applies when both ureters are repositioned within the same operative episode, a situation seen with bilateral reimplantation for vesicoureteral reflux, bilateral retrocaval or retroiliac anomalies, or extensive retroperitoneal fibrosis encasing both tubes and requiring bilateral ureterolysis and transposition. Addressing both ureters together often reflects a systemic or bilateral congenital condition rather than two unrelated unilateral problems, and the operative approach may be staged through a single midline or transperitoneal exposure to reach both structures. Coders should confirm from the operative report that both ureters were truly repositioned in the same surgical episode before applying this bilateral body part value; if only one ureter was addressed, or if the two sides were treated as distinctly separate objectives at different times, the single-ureter values are used instead.
Approach: Percutaneous Endoscopic
Percutaneous Endoscopic combines a puncture through skin or mucous membrane with insertion of an endoscope to visualize the procedure internally, as in laparoscopic cholecystectomy. It is distinguished from plain Percutaneous by the presence of scope-guided visualization, and from Via Natural or Artificial Opening Endoscopic by its route being a new puncture rather than an existing orifice or stoma.
Coding & Documentation
The operative note needs to describe the structure being moved and confirm that the objective was relocation rather than removal or reconstruction with foreign material. This includes procedures for undescended or ectopic kidneys, correction of ureteral malposition, and pyeloplasty when it is performed primarily to reposition the renal pelvis and ureter rather than to excise a stricture.
A common error is coding pyeloplasty as Repair when the surgeon's actual technique involved detaching and relocating the ureteropelvic segment, which fits Reposition more precisely. Coders should also watch for procedures that combine repositioning with excision of a narrowed segment, since both root operations may need to be captured depending on what was documented.