Urology Coding Alert

Question: My physician performed removal of a nephrostomy tube, an antegrade ureteroscopy with holmium laser lithotripsy and removal of a ureteral stone, ureteral stent insertion, and nephrostomy tube exchange. The fragmented ureteral stone was basketed and removed. Finally, by using an antegrade approach, my physician placed a 4.8x26 JJ stent and a 20 French nephrostomy tube. Which codes should I report on my claim?

AAPC Forum Member

Answer: You should report the following codes on your claim:

• 50435 (Exchange nephrostomy catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/ or fluoroscopy) and all associated radiological supervision and interpretation)) for the change of the nephrostomy tube
• 50961 (Ureteral endoscopy through established ureterostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with removal of foreign body or calculus) for the antegrade treatment of the ureteral stone
• 50553 (Renal endoscopy through established nephrostomy or pyelostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with ureteral catheterization, with or without dilation of ureter) for the antegrade stent placement.