Urology Coding Alert

Question: How should I report a cystoscopy and change and replacement of right ureteral stent through an ileal conduit loop? Massachusetts Subscriber Answer: When your urologist is changing an externally accessible ureteral stent exiting from the ileal stomal ostium and using radiological control without any endoscopy of the loop, you should report 50688 (Change of ureterostomy tube or externally accessible ureteral stent via ileal conduit) for unilateral or bilateral exchanges. If your urologist uses imaging guidance, you should also report 75984 (Change of percutaneous tube or drainage catheter with contrast monitoring [e.g., genitourinary system, abscess], radiological supervision and interpretation). Append modifier 26 (Professional component) to show that you are only coding for your physician's role in the monitoring. If your urologist does an endoscopic exchange, use 44383 (Ileoscopy, through stoma; with transendoscopic stent placement [includes predilation]) for either unilateral or bilateral placement. In this case, you should also report 52310 [...]