Physician coded this report with cpt codes 50393-Ureteral Stent Placement with74480 S&I; 53899-Ureteroplasty; 74485 S&I Please assist. Thanks
Indication: ureteral stent placement patient has a history of cystectomy, and ileal conduit. Previously, patient has had stenosis in the left ureter.
Comparison: None.
Gen. anesthesia was used.
Fluoroscopy time: 3.7 minutes
Findings: Prior to the exam, the risks and benefits of a exchange of a left internal/external nephroureteral stent for a internal double-J stent were discussed with the patient and informed consent was obtained. Patient was placed prone on the fluoroscopy table and the left flank was prepped and draped in normal sterile fashion. Contrast was injected which demonstrated the nephroureteral stent was in good position. A Bentson guidewire was then advanced, and the nephroureteral stent removed. A 7 French 23 cm vascular sheath was then placed, and a safety guidewire was placed in the left renal pelvis. Next, a pullback pyelogram was performed, which demonstrated stenosis in the distal left ureter. Over a Bentson guidewire, ureteroplasty was performed with a 6 mm x 4 cm balloon. Another pullback pyelogram was performed, which demonstrated improved patency of the left ureter. Next, a 26 cm x 6 French internal double J stent was advanced with its distal end in the distal ileal conduit
and the proximal and in the left renal pelvis. The safety wire was then removed.
Impression:
Impression:
1. Successful exchange of a left internal/external nephroureteral stent with a internal 26 cm x 6 French double-J stent.
Plan: Patient will return to urology in 3 months for a stent exchange.
Indication: ureteral stent placement patient has a history of cystectomy, and ileal conduit. Previously, patient has had stenosis in the left ureter.
Comparison: None.
Gen. anesthesia was used.
Fluoroscopy time: 3.7 minutes
Findings: Prior to the exam, the risks and benefits of a exchange of a left internal/external nephroureteral stent for a internal double-J stent were discussed with the patient and informed consent was obtained. Patient was placed prone on the fluoroscopy table and the left flank was prepped and draped in normal sterile fashion. Contrast was injected which demonstrated the nephroureteral stent was in good position. A Bentson guidewire was then advanced, and the nephroureteral stent removed. A 7 French 23 cm vascular sheath was then placed, and a safety guidewire was placed in the left renal pelvis. Next, a pullback pyelogram was performed, which demonstrated stenosis in the distal left ureter. Over a Bentson guidewire, ureteroplasty was performed with a 6 mm x 4 cm balloon. Another pullback pyelogram was performed, which demonstrated improved patency of the left ureter. Next, a 26 cm x 6 French internal double J stent was advanced with its distal end in the distal ileal conduit
and the proximal and in the left renal pelvis. The safety wire was then removed.
Impression:
Impression:
1. Successful exchange of a left internal/external nephroureteral stent with a internal 26 cm x 6 French double-J stent.
Plan: Patient will return to urology in 3 months for a stent exchange.