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Radiology Coding Alert

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Nail Nephrostomy Coding

Published on Mon May 11, 2009

Question: Which CPT codes should I report for the following services performed at a single encounter for right and left nephrostomy tube placement? " 21-gauge needle inserted into left renal pelvis under fluoro " contrast injections to confirm needle position " guidewire advanced into left renal pelvis " nephrostomy catheter placed in pigtail position in left renal pelvis " urine removed through nephrostomy catheter " contrast injection to check catheter function " above services repeated for right renal pelvis " RS&I for both procedures. Wyoming Subscriber Answer: Code 50392 (Introduction of intracatheter or catheter into renal pelvis for drainage and/or injection, percutaneous) covers all of the services you describe except for the radiological supervision and interpretation (RS&I). You should report the bilateral 50392 service according to your payers preference, such as appending modifier 50 (Bilateral procedure) to a single line item of 50392 or reporting 50392, 50392-50. The Medicare Physician [...]
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