Urology Coding Alert

Question: How can we code what the urologist called a "ureteroplasty procedure"? The operative note says that he performed "a renal/flank percutaneous access with antegrade passage of a dilating balloon through the renal pelvis down the ureter under radiological control and the dilation of an enteroureteral postoperative stricture."


Colorado Subscriber

Answer: Report 50953-52 (Ureteral endoscopy through established ureterostomy, with or without irrigation, instillation or ureteropyelography, exclusive of radiologic service; with ureteral catheterization, with or without dilation of ureter; reduced services) for the dilation of the ureterointestinal anastomosis stricture. Append modifier -52 because the urologist did not actually perform an endoscopy, just the ureteral stricture dilation. This describes the "ureteroplasty" the urologist performed.

For the radiological studies associated with 50953, report 74485-26 (Dilation of nephrostomy, ureters or urethra, radiological supervision and interpretation; professional component). Modifier -26 shows that the urologist did not perform the technical component of the radiology service, or that he does not own the x-ray equipment or pay for the technician's time or the contrast agent used.

Report 50393 (Introduction of ureteral catheter or stent into ureter through renal pelvis for drainage and/or injection, percutaneous) for the urologist's access to the system. Code 50393 includes bundled codes 50390 (Aspiration and/or injection of renal cyst or pelvis by needle, percutaneous) and 50392 (Introduction of intracatheter or catheter into renal pelvis for drainage and/or injection, percutaneous), so do not report those separately. Report 74480-26 (Introduction of ureteral catheter or stent into ureter through renal pelvis for drainage and/or injection, percutaneous, radiological supervision and interpretation; professional component) for the radiological studies associated with 50393.