# Cystoureteroscopy, right stone basket extraction, retrograde pyelogram, stent



## akj (Feb 5, 2014)

Please see below.  For anesthesia charges, would you code 00918 or 01922?

OPERATION PERFORMED: 
Cystoureteroscopy, right stone basket extraction, retrograde pyelogram, stent 
insertion. 
DRAIN: 
A 7-French variable length stent. 

DESCRIPTION OF PROCEDURE: 
Patient was taken down to suite, after time out and briefing were done patient was 
then intubated and placed in dorsal lithotomy position. Patient's perineum was 
prepped and draped in the usual sterile fashion. There vaginal exam is negative 
for any masses, no cystocele. Good apical support. Urethra is entered, no 
masses are seen. Bladder was surveyed. There are no foreign bodies or masses 
seen. Ureter was entered, found normal position, normal caliber. Right UO was 
identified and a wire was placed into this. A rigid scope was placed into this 
and taken to the level distally. The stone was identified, grasped with a Cook 
and circle basket and removed in 1 piece. I replaced the scope and take this up 
into the collecting system. Patient has a large renal pelvis. I then removed this 
partially and did a retrograde pyelogram showing again a very large dilated 
renal pelvis with hydroureter. Leaving the wire in place I placed a 7-French 
variable length stent with good curl in the renal pelvis and distally into the 
bladder to help to increase the drainage from that right side to decrease any 
possibility for any urinoma formation. Patient's bladder was drained.


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## MedCoder51 (Feb 5, 2014)

*Cysto with Stone Extraction*

It would be appropriate to use 00918 since it involves stone manipulation, extraction, or fragmentation. Code 01922 is used for radiology procedures such as MRI's.


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## akj (Feb 6, 2014)

Historically, I have been using the 00918 for these services.  However, I was second guessing myself because of the retrograde pyelogram.

Thanks for the input!


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