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Wiki Renal cyst aspiration and ethanol inj

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hwilcox07

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REPORT READS: Using u/s guidance, an 18 gauge needle was placed into cyst in lower pole of left kidney. Small amount of fluid was aspirated confirming needle tip in cyst. A wire was placed through needle and needle was removed. A pigtail catheter was inserted but no fluid was able to be withdrawn so catheter was removed and 18 gauge needle was reinserted. Again, a small amount of fluid was aspirated confirming needle tip in the cyst. Attempts were made to aspirate the cyst which were complicated by numerous septations present. 4 ml of sterile 95% ethanol was injected into the cyst, patient was turned in multiple positions for 10 minutes and attempts were made to aspirate the ethanol which yielded only 1 ml of clear fluid. The cyst was flushed with saline. Would 50390/74470 be the only CPT codes to use in this scenario?
 
In my opinion, I would use 76942/50390. The 74470 code is for a contrast evaluation which is not supported by the documentation provided. The only other code that I've seen suggested for ethanol injection was 53899 (UPC) however 50390 covers both aspiration &/or injection so it's your best option.
 
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