# Conversion of nephroureterostomy tube to a retrograde nephrostomy



## MELJNBBRB (Aug 23, 2013)

I am thinking 50392/74475 but the conversion is throwing me off. Any input is appreciated.
Melissa Bedford,CCS,CPC


INDICATION: 77-year-old male with history of bladder and prostate cancer. Patient had a nephro ureterostomy catheter placed for left-sided hydronephrosis. Patient is here for conversion of nephroureterostomy tube to a retrograde nephrostomy.

MEDICATIONS: 

1. 1% lidocaine for local anesthesia.
2. Deep sedation was provided by the anesthesia service.

Fluoroscopy time: 23.6 minutes.

FINDINGS:

The indwelling nephroureterostomy catheter was prepped and draped in usual sterile fashion as well as the ostomy for ileal conduit. A Glidewire was placed over the nephroureterostomy catheter and the catheter was removed. Using assistance with a Kumpe 
catheter, the ileal conduit was then negotiated and the Glidewire eventually exited the ostomy. In retrograde fashion over the Glidewire, a 10 French 45 cm all-purpose drainage catheter was placed. Injection of contrast revealed the tip of the catheter 
within the left renal pelvis. Sterile covering was placed over the ostomy.

  Impression: IMPRESSION:

Successful conversion of nephroureterostomy to 10F 45 cm retrograde nephrostomy. Exchange of the retrograde nephrostomy catheter is recommended every 3 to 6 months.


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## Jim Pawloski (Aug 27, 2013)

SASSYLDY27 said:


> I am thinking 50392/74475 but the conversion is throwing me off. Any input is appreciated.
> Melissa Bedford,CCS,CPC
> 
> 
> ...



Dr. Z just answered this question in one of his news letters.  Bill for a Nephrostomy Catheter Exchange (50398/ 75984)
HTH
Jim Pawloski, CIRCC


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## MELJNBBRB (Aug 28, 2013)

Thank you Jim for your reply! Greatly appreciated!! Have a good day!


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