CODING Q&A C. Matt Hawkins, MD
New 2016 genitourinary codes Twelve new codes were established to more accurately describe percutaneous, image-guided procedures performed in the genitourinary system. Most notably, image guidance is no longer separately reportable. Codes 50392, 50393, 50394 and 50398 have been deleted. Guidelines that have been added to the CPT Manual provide specific instruction for appropriate use of these codes.
Does code 50693 include the replacement of the existing nephrostomy tube following the placement of
the ureteral stent?
Yes. CPT code 50693 includes all drainage catheter manipulations and exchanges (when performed), as well as
diagnostic nephrostograms and/or ureterograms (when performed), imaging guidance (e.g., ultrasonography and/or fluoroscopy), and all associated radiological supervision and interpretation. Do not report code 50435 in conjunction with 50693.
Can you clarify the use of CPT code 50395?
Code 50395 describes the establishment of a new percutaneous access into a renal collecting system for
subsequent lithotripsy or additional surgical procedure(s). This code should be used when a sheath or access catheter is placed only for the purposes of the access into the pelvis or ureter for an
operative procedure to follow. If a full and complete procedure such as nephrostomy drainage tube or ureteral stent is performed, one should use the appropriate code for placement of that tube or stent.
Can I report 50706 for ureteral dilation for each lesion dilated in the ureter?
No, this code should only be reported once per ureter, regardless of the number of treated lesions
within the ureter.
Disclaimer: SIR is providing this billing and coding guide for educational and information purposes only. It is not intended to provide legal, medical or any other kind of advice. The guide is meant to be an adjunct to the American Medical Association’s (AMA’s) Current Procedural Terminology (2014/CPT®). It is not comprehensive and does not replace CPT. Our intent is to assist physicians, business managers and coders. Therefore, a precise knowledge of the definitions of the CPT descriptors and the appropriate services associated with each code is mandatory for proper coding of physician service. Every reasonable effort has been made to ensure the accuracy of this guide; but SIR and its employees, agents, officers and directors make no representation, warranty or guarantee that the information provided is error-free or that the use of this guide will prevent differences of opinion or disputes with payers. The publication is provided “as is” without warranty of any kind, either expressed or implied, including, but not limited to, implied warranties or merchantability and fitness for a particular purpose. The company will bear no responsibility or liability for the results or consequences of the use of this manual. The ultimate responsibility for correct use of the Medicare and AMA CPT billing coding system lies with the user. SIR assumes no liability, legal, financial or otherwise for physicians or other entities who utilize the information in this guide in a manner inconsistent with the coverage and payment policies of any payers, including but not limited to Medicare or any Medicare contractors, to which the physician or other entity has submitted claims for the reimbursement of services performed by the physician.
SPRING 2016 |
IR QUARTERLY 27
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