Q&A Some help with urinary system radiology codes

[Linda]

Hello. I am working on the urinary system code 50551 and 50570 descriptor states exclusive of radiological services- I get that part so I go- to fluoroscopic section in radiology section- then my day gets hazy- what in the world would match up with range of codes- via stoma or incision aren't the golden words, renal, has chooses,endoscopy for oncology chooses, but I am missing what I need to be looking for in this code range. Can any one give me a hand. I have run out of things to think of. Thanks

 

[Linda]

Hello me again. I know it is late but I have high hopes of getting up tommorow and seeing lots and lots of help. I have to test thur. Dang didn't realize I missed this months webinar. I love those, great info for what we are learning. I'm thinking it depends on what they are looking at and what was used MRI, fluoroscopic guideance, CT, etc. Good night all.

 

[Laureen]

Hi Linda - I'm a little fuzzy on what you are asking exactly

50551 - Renal endoscopy through established nephrostomy or pyelostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service

50570 - Renal endoscopy through nephrotomy or pyelotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service

The difference between the two codes is one is through an existing opening and the other is through a temporary incision.

Regarding the radiology piece you need to go by your documentation.

Here is the Lay View from SuperCoder - I highlighted the part that gives us some insight on the radiological piece.

Physician Responsibility
In this procedure, the surgeon inserts an endoscope through a previously established opening between the collecting system of the kidney and the exterior of the body (skin) or opening between the renal pelvis to the skin to examine the kidney, renal pelvis, and ureter. First the surgeon disconnects the external urinary drainage bag from the nephrostomy or pyelostomy tube. A guidewire is then moved forward through the nephrostomy tube and nephrostomy tube is then pulled out over the wire. The surgeon may use some surgical instruments to widen the opening passageway. Once pathway is widened, the surgeon inserts an endoscope, which is a small, flexible tube with a fastened optical system, into the kidney through an established nephrostomy or pyelostomy tract to analyze the interior structures of the renal collecting system. For better visual perception, the physician may use sterile saline solution into the area of the renal collecting system. The physician may instill some other therapeutic solutions into the kidney or contrast material may be used for x–ray photography of the ureter and renal pelvis. Once examination is completed, the surgeon withdraws all the instruments, replaces the tubes, and reconnects the external urinary drainage bag to the tubes for temporary urine flow.

If that's not what you're looking for let us know.

 

[Linda]

Hi queen thanks I think I just did the temporary freakout,still studing and the sun is come up sysndrome. I need to go through the radiology section and look at the possibilities for what structure is being looked at, to know what codes could be used. I like it much better when they have the chooses listed under the codes. Have a good one.