pharmon
Guru
This one has had me baffled a few days. I've worked it and laid it down, worked on it some more, and today I hope someone can just check behind me. I am sorry its lengthy. I feel I'm overlooking something. Thanks.
The flanks are prepped & drapped in a sterile fashion. The previously placed nephrostomy tubes are prepped and draped as well. Initially a benson wire was advanced thru the LT Nephrostogram with contrast injection into the distal ureter shows complete obstruction of the distal ureter with mild hydroureter. Multiple attempts at passing a wire into the urinary bladder were unsuccessful. Then a Benson wire was advanced through the RT nephrostomy tube to the ureterovesical junction and contrast injection made. This demonstrates a tight stenosis and a 5 french cathe was placed in the urinary bladder. A 4 mm wide balloon was placed at the level of stenosis at the RT ureterovesical junction and balloon dilation performed. Then a 8.5 french nephroureterostomy tube was passed into the urinary bladder and exited the right flank. Pt. tolerated procedure well.
I coded, LT 50393, 74425, 50398 & 75984 RT 50393, 74480.
The flanks are prepped & drapped in a sterile fashion. The previously placed nephrostomy tubes are prepped and draped as well. Initially a benson wire was advanced thru the LT Nephrostogram with contrast injection into the distal ureter shows complete obstruction of the distal ureter with mild hydroureter. Multiple attempts at passing a wire into the urinary bladder were unsuccessful. Then a Benson wire was advanced through the RT nephrostomy tube to the ureterovesical junction and contrast injection made. This demonstrates a tight stenosis and a 5 french cathe was placed in the urinary bladder. A 4 mm wide balloon was placed at the level of stenosis at the RT ureterovesical junction and balloon dilation performed. Then a 8.5 french nephroureterostomy tube was passed into the urinary bladder and exited the right flank. Pt. tolerated procedure well.
I coded, LT 50393, 74425, 50398 & 75984 RT 50393, 74480.