# Billing for PCNL



## kmartinez (Mar 23, 2018)

Dr. performed: 
1. Cystourethroscopy with right double-J ureteral stent removal and replacement with a ureteral access stent. 
2. Introduction of guide into renal pelvis percutaneously with dilation to establish nephrostomy tract.
3. Percutaneous nephrolithotomy with endoscopy and lithotripsy of stone, 1.5 cm in size. 
4. Retrograde and antegrade pyelogram to delineate percutaneous access and nephrostomy tube placment. 

It appears CPT 50080 covers everything such as the dilation, endoscopy, lithotripsy and stenting as mentioned in the CPT description. 

So therefore I only bill 50080 and 74420-26 for the retrograde, is that correct? 

I do not bill 50395 ? and what about the tube placement? I dont' bill that either? 

Trying to understand... Thanks in advance! 

KAM - CPC


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## kmartinez (Jul 9, 2018)

*Any help please*

I would really appreciate it if somebody would help me understand billing for PCNL in regards to CPT 50395 and placement of a nephrostomy tube.


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## debbiesom (Jul 12, 2018)

the nephrostomy tube placement 50392 is bundled with 50080 

If the urologist does the Renal Access you can bill 50395 but if this is done prior in IR then you cannot

and yes Stenting, fragmentation, dilation and basket extraction is included in 50080, 50081

Debbie, CPC, CUC


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## drewvinson23 (Jul 12, 2018)

Actually, the coding for PCNL has changed in recent years.

Here is a short article from the AUA in regards to the coding of PCNL and the dilation of the tract/nephrostomy tube placement:

https://community.auanet.org/policy...eous-nephrostolithotomy-and-nephrostomy-tract

Sincerely,

Drew Vinson
CPC 
NW Urology


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