Wiki Ureteral stent placment during kidney transplantation

[Listermann]

Does anyone know if billing a kidney transplantation 50360 with the placement of a ureteral stent 50605 is compliant? We have billed both out together and have gotten paid for the stent but a recent presentation has made us think otherwise about billing out the stent. Does anyone know something we do not or have suggestions?

 

[Kelly_Mayumi]

I don't see why you can't report it. The renal transplant codes are in the kidney section and the ureter stent is in the ureter section and neither procedure is listed as a "seperate" service. CCI came out earlier this year that a ureter stent would bundle to ureter procedures, so in my opinion, I think it should be okay to bill.

 

[cmcglynn]

myself and some colleagues ponder the same. Although cci does not show as bundled - -
my stance on it is this: The stent placement 50605 - reads "ureterotomy for insertion of indwelling stent, all types". A 'new' ureterotomy is not being performed to place the stent - as the ureter (s) are already transected for the placement of the renal allograft. The actual anastamosis/cystostomy/ureteroneocystostomy often, (if not mostly), is constructed OVER the double-J ureteric stent; hence, not making it a separate ureterotomy for placement of a stent. Physician/medical periodicals - stents are included and a given after renal transplantation to prevent stricture/obstruction. This is one of those 'grey' areas that us coders just love! Right? So, yes I think you can support if audited WHY you added and can prove it isn't cci or cpt bundled. But on the other hand - I view it as included as indicated above. I do not add the 50605 with the 50360