nabernhardt
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just wanting to double check myself
I came up with CPT codes 52351 and 74420. thanks
OPERATION:
1. Cystoscopy.
2. Right retrograde pyelogram.
3. Right ureteroscopy.
PROCEDURE: The patient was anesthetized with general anesthesia and repositioned in
lithotomy. His perineum was prepped and draped in a sterile manner. The Storz 22 French
cystoscope was inserted under direct vision using video. There were no urethral strictures. His prostate was small with no obstruction. Both orifices were normal. I then injected contrast up the right ureter with a cone-tipped catheter and on fluoroscopy, the ureter was visualized. It took a loop up by the suspected site of the obstruction, suggesting that it actually was from a crossing vessel and not an intrinsic UPJ obstruction. I then passed the Storz mini ureteroscope up to this area and injected contrast and that confirmed my suspicion that it was likely from a crossing vessel. The renal collecting system was markedly dilated, again consistent with a UPJ obstruction.I was unable to pass the ureteroscope all the way into the kidney.
The scope was removed. The bladder was then drained with the cystoscope sheath and the scope was removed. The patient tolerated the procedure well. There were no complications and he was transferred to recovery in stable condition.
I came up with CPT codes 52351 and 74420. thanks
OPERATION:
1. Cystoscopy.
2. Right retrograde pyelogram.
3. Right ureteroscopy.
PROCEDURE: The patient was anesthetized with general anesthesia and repositioned in
lithotomy. His perineum was prepped and draped in a sterile manner. The Storz 22 French
cystoscope was inserted under direct vision using video. There were no urethral strictures. His prostate was small with no obstruction. Both orifices were normal. I then injected contrast up the right ureter with a cone-tipped catheter and on fluoroscopy, the ureter was visualized. It took a loop up by the suspected site of the obstruction, suggesting that it actually was from a crossing vessel and not an intrinsic UPJ obstruction. I then passed the Storz mini ureteroscope up to this area and injected contrast and that confirmed my suspicion that it was likely from a crossing vessel. The renal collecting system was markedly dilated, again consistent with a UPJ obstruction.I was unable to pass the ureteroscope all the way into the kidney.
The scope was removed. The bladder was then drained with the cystoscope sheath and the scope was removed. The patient tolerated the procedure well. There were no complications and he was transferred to recovery in stable condition.