Question: What code should I report for the placement of a ureteral stent through an established nephrostomy, when the urologist didn't use an endoscope? Answer: Since there is no special CPT code for this service, you can use 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) and append modifier 52 (Reduced services). Answers to Reader Questions and You Be the Coder contributed by Michael A. Ferragamo, MD, FACS, clinical assistant professor of urology, State University of New York, Stony Brook; and Morgan Hause, CCS, CCS-P, privacy and compliance officer for Urology of Indiana LLC, a 31-urologist practice in Indianapolis.
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Using modifier 52 indicates that the physician didn't perform the complete procedure. In this case, it tells the carrier that the urologist did not use endoscopy when placing the ureteral catheter, but that he did perform the procedure through an established nephrostomy as indicated in the CPT description of 50553.