CCSD code M1820 – Excision of segment of ureter

Key takeaways

CCSD code M1820 is excision of segment of ureter, a partial ureterectomy that removes one diseased length and keeps the kidney.

It lines up with OPCS-4 M18.2 and sits with the ureter codes in Chapter 12 of the CCSD schedule.

The schedule lists unacceptable combinations with M1820, including M2090 and M3000, so check every extra code against it before the claim goes out.

Pair it with the diagnosis the operative note supports, such as an N13 stricture code or C66 for a ureteric cancer.

Pabau tracks the authorization code on each patient’s case and warns when one is missing, so an M1820 claim doesn’t go out without it.

What CCSD code M1820 covers, and where it stops

M1820 pays for removing one segment of the ureter, the tube that carries urine from the kidney to the bladder. The surgeon cuts out the diseased length, and the kidney stays. Clinicians call this a segmental or partial ureterectomy.

CCSD codes are the procedure codes UK private medical insurers use, maintained by the Clinical Coding & Schedule Development group. M1820 lines up with OPCS-4 M18.2, the NHS classification’s code for the same operation. That shared description helps hospital coders and practice billers land on the same answer.

Knowing where the code stops matters just as much. These neighbors are billed differently:

• Whole-ureter removal. A nephroureterectomy takes the kidney and the full ureter, and it has its own code.
• Endoscopic work. Looking inside the ureter with a scope is not an excision. CCSD code M3000 covers endoscopic examination of the ureter.
• Freeing the ureter without removing it. Ureterolysis is a separate entry, M2530.
• The anesthetic. The anesthetist claims their own fee, so it never appears on the surgeon’s M1820 claim.

The map below sets M1820 beside the ureter codes it’s most often confused with.

Surgeons remove a ureter segment for three main reasons

The operation suits a problem confined to one short length of ureter. Three situations come up again and again.

• Stricture. A narrowed section blocks drainage from the kidney. It often follows stone surgery, radiotherapy or an earlier pelvic operation.
• Tumor. A small, low-risk urothelial tumor sits in the ureter. Removing the segment treats it while sparing the kidney.
• Injury. Trauma or surgery has damaged a section that can’t be repaired in place.

How the surgeon restores drainage depends on where the segment was. A mid or upper section is usually joined end to end. A section near the bladder often means replanting the ureter into the bladder instead. Replantation has codes of its own, such as M2080 for one side. That second step is where most coding trouble starts.

Pair M1820 with a diagnosis code the note supports

UK insurers expect an ICD-10 code on the claim. Take it from the indication in the operative note, not from the name of the procedure. These codes fit the usual reasons for the operation.

If the final histology changes the picture, update the diagnosis before you invoice. A claim sent with a stricture code and corrected to C66 later invites a query.

Check the combination rules before you add a second code

The CCSD schedule lists unacceptable combinations for M1820, including M2090 and M3000. Neither belongs on the same claim.

• M2090, a ureter replantation code. Keep it off an M1820 claim, even when a replantation took place.
• M3000, endoscopic examination of the ureter. A look up the ureter during the same operation doesn’t earn a second line.

The full list may be longer. Other ureter codes, including M1120 for diagnostic ureterorenoscopy and M2530 for ureterolysis, may carry the same flag. Check each one in the CCSD schedule before you add it.

The operative note has to show what came out

A vague note is the quickest route to an insurer query on a partial ureterectomy. Before the claim goes out, check that the note states:

• The side, and which part of the ureter was involved: upper, middle or lower.
• The length of the segment removed, and why that section was chosen.
• The indication, in words that match the ICD-10 code on the claim.
• How drainage was restored, by an end-to-end join or a replantation, and whether a stent was left.
• That the specimen went for histology, so the diagnosis can be confirmed later.

The signed consent form and pre-operative imaging belong in the same record. Digital clinical forms make that record easier to keep consistent across surgeons.

How an M1820 claim moves from referral to payment

Most of the work happens before the invoice exists. Here’s the usual sequence for a planned operation.

1. Check the policy. Confirm the patient’s cover, and any excess or shortfall, before the operation is booked.
2. Get pre-authorization. Give the insurer M1820, the ICD-10 code and the planned date. Record the reference it issues.
3. Operate and write the note. Capture the details listed above on the day, while they’re fresh.
4. Confirm the histology. Update the diagnosis code if the pathology report changes it.
5. Submit the claim. Send M1820, the ICD-10 code and the authorization reference, usually electronically through Healthcode or the insurer’s own portal.
6. Reconcile the payment. Match the remittance to the claim, then chase any shortfall with the insurer or the patient.

Each clinician bills separately. The surgeon claims M1820, while the anesthetist and the hospital send their own invoices.

A worked example: A short stricture after stone surgery

Here’s how a straightforward claim might come together. The case is illustrative.

A patient develops a 2 cm stricture in the middle third of the left ureter after an earlier ureteroscopy. Imaging shows the kidney above it has swollen. The surgeon removes the narrowed segment and joins the healthy ends over a stent.

The biller codes M1820 with N13.1, because the stricture has caused hydronephrosis. The note confirms the side, the segment length and the end-to-end repair. The surgeon also inspected the ureter with a scope in the same session. That look stays off the claim, because the schedule lists M3000 as an unacceptable combination with M1820.

Histology comes back benign, so N13.1 stands. The authorization reference was issued before surgery, and it goes on the invoice exactly as issued.

Before you submit: A six-point check

• The code is M1820, not a whole-ureter or endoscopic code.
• The ICD-10 code matches the indication and the final histology.
• No code the schedule lists as an unacceptable combination, such as M2090 or M3000, sits on the same claim.
• Any other ureter code has been checked against the combination rules.
• The authorization reference matches this patient, this date and this procedure.
• The operative note states the side, the segment and the repair.

Common M1820 mistakes, and how to fix each one

How Pabau keeps M1820 claims on one record

Partial ureterectomy billing passes through several hands. The surgeon writes the note, pathology reports days later and the biller holds the authorization reference.

Pabau, the practice management platform we build, keeps those pieces on one patient record. Through its claims management software, UK practices send claims to Healthcode and BUPA from that same record.

The authorization code, its dates and its sessions are tracked on the patient’s case. Pabau warns you when one is missing, so the reference is in place before the claim leaves.

For an M1820 claim, the histology update and the authorization reference sit beside the claim they belong to. An insurer query weeks later gets answered from one screen.

Keep every M1820 claim tied to its record

Pabau tracks the authorization on each patient’s case, warns when it’s missing and sends UK claims through Healthcode and BUPA. Billing teams answer insurer queries from one record.

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Conclusion

M1820 looks simple on paper. One segment of ureter comes out, and one code goes on the claim. The difficulty sits in the steps around it.

Keep the diagnosis tied to the histology, keep blocked codes off the claim and make the note say exactly what was removed. Those three habits answer most insurer questions before anyone asks them.

Build them into the workflow rather than into someone’s memory. A check held in the system survives a busy list and a change of staff.

Book a demo to see how Pabau keeps CCSD codes, authorization references and operative notes on one record.

Continue your research

Need the wider view of the CCSD schedule? Bupa CCSD codes covers the full Bupa schedule with billing rules and payer-specific guidance.

Replanting the ureter after a low excision? CCSD code M2080 explains how unilateral replantation of the ureter into the bladder is billed.

Coding a scope of the ureter instead? CCSD code M3000 sets out the rules for endoscopic examination of the ureter.

Freeing a trapped ureter rather than removing it? CCSD code M2530 covers unilateral ureterolysis and how it is claimed.

Checking what a procedure is worth under Bupa? Bupa procedure codes and fee schedule explains how the fee schedule works and where to verify a current rate.

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