Wiki bilateral Nephrostogram and bilateral nephrostomy tube exchange

[Misty Dawn]

Need a second opinion on my codes for this procedure please! I am not sure if I am coding this correctly. Thank you, Thank you for any feedback!
A bilateral Nephrostogram and bilateral nephrostomy tube exchange was performed. Medical necessity supports coding the diagnostic procedure separate with a 59 modifier due to stricture of ureters with hydronephrosis found on both sides.

My codes are as follows:

50398-50-RT
50398-LT
(or 50398-50 on a signal line depending on payer preference)

50394-XU-50-RT
50394-XU-LT
(or 50394-XU-50 on a signal line depending on payer preference)

75984- enter "2" for units
(Has MUE of "2" so can enter unit of 2)

74425-XS-RT
74425-LT
(has MUE of "1" so XS (59) modifier needs to be used and probably have to appeal)

 

[christoff9]

You don't need 50 and LT/RT or XS and LT/RT. One or the other depending on the insurance.

As far as your diagnostic, if the patient is coming in for a problem with their tubes, you can charge it. If they are coming in for a routine change, you can't. All of these patients have either a stricture or hydronephrosis or both so that doesn't justify the charge.