# need help with stents



## ggparker14 (Dec 7, 2010)

How do you know with the insertion of Double J stents if they are indwelling or not?  If they are indwelling, is 52332 the appropriate code and if not, what code is appropriate for insertion of stents that are not indwelling?


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## Kelly_Mayumi (Dec 8, 2010)

I pulled this information from the AUA website.  Maybe it will be helpful?

Q. What is the difference between temporary and permanent stents? 

A. According to CPT® definition in the guidelines of the Ureter and Pelvis section, temporary stents are those that are inserted at the beginning of a surgical procedure and then removed once the procedure has been completed. A permanent stent is a stent that is inserted during the surgery but will be removed at a later date. 

However, this wording reflects the fact that in the early days of endo-urology, all catheters inserted into ureters were referred to as "stents" and the two terms were used interchangeably. Subsequently technology has evolved and virtually all stents are designed to remain indwelling in the patient. Ureteral catheters, on the other hand are typically inserted and removed in the same therapeutic intervention. 

Temporary ureteral catheters are open-ended straight tubes which are placed within the ureter to perform retrograde pyelography or to collect selective ureteral urine for cytologies. In contrast, insertion of an indwelling or non-temporary stent (CPT® code 52332) involves the placement of a specialized self-retaining stent (e.g. J stent) into the ureter to relieve obstruction or treat ureteral injury. This requires a guidewire to position the stent within the kidney. The ends of the stent are coiled so that one end is anchored in the renal pelvis while the other is in the bladder thereby preventing migration. These indwelling stents are not removed at the same patient encounter. It follows that when CPT® code 52332 is reported with any of the codes in this family (52320-52355) it is being used to report insertion of an indwelling stent, and not a temporary ureteral catheter (52005). It would be expected that the operative procedure note would reflect the appropriate procedures performed.


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## ggparker14 (Dec 8, 2010)

Thank you for your help.


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## caromissunc1 (Dec 10, 2010)

*re: stents*

My docs use double J stents quite frequently.  I have had much success with the 52332 code.  
Stents may be left for an undetermined period of time.  I have posted removals after 2 days, and one after almost a year.
Hope this helps!


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## astanley (Aug 23, 2016)

*RT DJ Ureteral Stent removed by hand-string protruding from urethra*

Is code 53899 the best possible code for this?  I can't find anything else for it.


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## michelleaapc2012 (Aug 23, 2016)

If it was pulled by hand and not with a scope, I believe it would be no charge.


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## JEYCPC (Aug 23, 2016)

michelleaapc2012 said:


> If it was pulled by hand and not with a scope, I believe it would be no charge.



If they have the strings and no cysto was done then it is included in the E/M code.


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