Wiki Ureterostomy and Nephrostomy

drobinson1

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Good morning Coders. I need help with the following report. I was thinking it was just a 74475/50392 but I want to be sure.

Impression: Left ureterostomy with a chronic distal stricture. Successul placement of the left trans-ureterostomy nephrostomy tube.

Procedure and findings: After obtaining informed consent the patient was placed on the angiography table in the supine position. His abdominal wall was prepped and draped in usual fashion. Using a 4-french dialator over a 0.035 inch glide wire, the patient's ureterostomy was accessed. The glidewire met resistance and could not be advanced more than 3cm into the ureterostomy. Contrast was injected under fluoroscopic guidance, which demonstrated a distal stricture. Using a 4-french Kunpe catheter over a 0.035angle guidewire, the stenosis was negotiated and the ureterostomy was cannulated successfully. With the catheter in the left renal pelvis, a 0.035 inch heavy duty guidewire was looped in the pelvis, and the catheter was exchanged for a 10-French nephrostomy tube. The pigtail was formed in the renal pelvism and the catheter was left open to drain into the patient's ureterostomy bag.
 
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