ureterostomy

DEFINITION of ureterostomy

A ureterostomy is a form of urinary diversion in which the ureter(s) are surgically redirected and anastomosed to the skin, creating a cutaneous stoma through which urine drains directly into an external collection appliance. It is most commonly performed as a cutaneous ureterostomy — either unilateral, bilateral (each ureter brought out separately), or as a transureteroureterostomy (TUU) where one ureter is joined to the other and then brought to the skin as a single stoma. It may also refer to ureteroureterostomy (ureter-to-ureter anastomosis, an internal bypass). Ureterostomy is typically reserved for patients who cannot tolerate more complex diversions (e.g., ileal conduit) due to age, comorbidities, or bowel compromise. It avoids the need for bowel segment use but carries risks including stomal stenosis, reflux, infection, and obstruction. It may be temporary (e.g., in trauma or pediatric obstruction) or permanent.

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ETYMOLOGY of ureterostomy

greek Ureter Greek ourētēr (οὐρητήρ), from ourein”To urinate”; the duct from kidney to bladder -o- Connecting vowel -stomy Greek stoma (στόμα); “Mouth” or “opening” → surgical creation of an opening; Full meaning”Surgical creation of an opening in/from the ureter”

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🏥 ICD-10-PCS Codes (Inpatient — Root Operation: Bypass, Body System: Urinary)

The key qualifier for cutaneous ureterostomy is destination character D = Cutaneous

✂️ Cutaneous Ureterostomy — Right Ureter:

Code	Description
0T160ZD	Bypass Right Ureter to Cutaneous, Open Approach
0T1607D	Bypass Right Ureter to Cutaneous with Autologous Tissue Substitute, Open
0T160JD	Bypass Right Ureter to Cutaneous with Synthetic Substitute, Open
0T160KD	Bypass Right Ureter to Cutaneous with Nonautologous Tissue Substitute, Open
0T164ZD	Bypass Right Ureter to Cutaneous, Percutaneous Endoscopic
0T1647D	Bypass Right Ureter to Cutaneous with Autologous Sub, Perc Endo
0T164JD	Bypass Right Ureter to Cutaneous with Synthetic Sub, Perc Endo
0T163JD	Bypass Right Ureter to Cutaneous with Synthetic Sub, Percutaneous

✂️ Cutaneous Ureterostomy — Left Ureter:

Code	Description
0T170ZD	Bypass Left Ureter to Cutaneous, Open Approach
0T1707D	Bypass Left Ureter to Cutaneous with Autologous Sub, Open
0T170JD	Bypass Left Ureter to Cutaneous with Synthetic Sub, Open
0T170KD	Bypass Left Ureter to Cutaneous with Nonautologous Sub, Open
0T174ZD	Bypass Left Ureter to Cutaneous, Percutaneous Endoscopic
0T174JD	Bypass Left Ureter to Cutaneous with Synthetic Sub, Perc Endo
0T173JD	Bypass Left Ureter to Cutaneous with Synthetic Sub, Percutaneous

✂️ Cutaneous Ureterostomy — Bilateral:

Code	Description
0T180ZD	Bypass Bilateral Ureters to Cutaneous, Open Approach
0T1807D	Bypass Bilateral Ureters to Cutaneous with Autologous Sub, Open
0T180JD	Bypass Bilateral Ureters to Cutaneous with Synthetic Sub, Open
0T180KD	Bypass Bilateral Ureters to Cutaneous with Nonautologous Sub, Open
0T184ZD	Bypass Bilateral Ureters to Cutaneous, Percutaneous Endoscopic
0T183JD	Bypass Bilateral Ureters to Cutaneous with Synthetic Sub, Percutaneous

🔀 Ureteroureterostomy (Internal — Ureter to Ureter):

Code	Description
0T160Z6	Bypass Right Ureter to Right Ureter, Open
0T160Z7	Bypass Right Ureter to Left Ureter, Open
0T170Z6	Bypass Left Ureter to Right Ureter, Open
0T170Z7	Bypass Left Ureter to Left Ureter, Open
0T164Z6	Bypass Right Ureter to Right Ureter, Perc Endo
0T174Z6	Bypass Left Ureter to Right Ureter, Perc Endo

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CODING AND NUANCES

🏥 ICD-10-CM Diagnosis Codes

Status Codes (existing ureterostomy):

Code	Description
Z93.6	Other artificial openings of urinary tract status ✅ (use for ureterostomy status)

Complication Codes — Incontinent External Stoma of Urinary Tract (applies to ureterostomy):

Code	Description
N99.520	Hemorrhage of incontinent external stoma of urinary tract
N99.521	Infection of incontinent external stoma of urinary tract
N99.522	Malfunction of incontinent external stoma of urinary tract
N99.523	Herniation of incontinent stoma of urinary tract
N99.524	Stenosis of incontinent stoma of urinary tract
N99.528	Other complication of incontinent external stoma of urinary tract

Complication Codes — Continent Stoma of Urinary Tract:

Code	Description
N99.530	Hemorrhage of continent stoma of urinary tract
N99.531	Infection of continent stoma of urinary tract
N99.532	Malfunction of continent stoma of urinary tract
N99.533	Herniation of continent stoma of urinary tract
N99.534	Stenosis of continent stoma of urinary tract
N99.538	Other complication of continent stoma of urinary tract

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🔧 CPT Codes (Outpatient/Professional Reference)

Code	Description
50750	Ureterocalycostomy, anastomosis of ureter to renal calyx
50770	Transureteroureterostomy, anastomosis of ureter to contralateral ureter
50780	Ureteroneocystostomy; anastomosis of single ureter to bladder
50820	Ureteroileal conduit (ileal bladder), including intestine anastomosis
50825	Continent diversion, including intestine anastomosis using any segment of small/large intestine
50830	Urinary undiversion (e.g., taking down ureterostomy/ileal conduit and reconnecting ureters to bladder)

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📝 Inpatient Coder Notes

• Device character matters: If a stent or tube is left in the ureter at the time of surgery, the device character changes from Z (no device) to a stent/drainage device character. Always check the operative note.
• Ureterostomy ≠ nephrostomy: Nephrostomy exits at the kidney (body part = kidney); ureterostomy exits at the ureter (body part = ureter). Don’t confuse them in PCS.
• Bilateral ureterostomy: Use the bilateral body part character (body part 8) rather than coding two separate procedures if both ureters are brought out simultaneously.
• Complication coding: A cutaneous ureterostomy is an incontinent external stoma, so the N99.52x series is your correct complication category — not N99.53x (continent) and not N99.51x (cystostomy).
• Z93.6 is the correct status code for a patient with a ureterostomy in place — there is no more specific code for ureterostomy specifically within Z93.

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DERIVATIONS of ureterostomy

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Query functionality

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Med roots Appendix A Prefixes Appendix B Combining Forms Appendix C Suffixes Appendix D Suffix forms