Shirleybala
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Hi
How to code change of nephrostomy thro ileal conduit.My codes are
50690
74425-26
50688
75984-26
Please confirm.
Clinical history: 52 year old male with history of bladder cancer
status post cystectomy and creation of ileal conduit, who
subsequently developed a distal right ureteral stricture. The
patient is status post numerous, unsuccessful attempts at ureteral
dilatation. The patient has an indwelling retrograde right
percutaneous nephrostomy. Referred for routine exchange.
Moderate Sedation was provided using IV versed and fentanyl
10 cc of isovue 300 were used as contrast.
Technique:
The procedure was initially discussed with the patient at length,
including risks benefits and alternatives. Risks discussed
included but not were not limited to sepsis, bleeding, etc.. The
patient understood, asked appropriate questions and signed
informed consent.
The right lower quadrant, ileostomy, and existing drainage
catheter were prepped and draped in usual sterile manner.
Initially contrast injected into the catheter demonstrated the
catheter tip within the right renal pelvis. Minimal hydronephrosis
is visualized.
Using seldinger technique, the catheter was exchanged out over a
Amplatz super stiff wire, and a new, 10.2 French, 45 cm all
purpose
drainage catheter with locking loop was placed, positioned with
the tube with the up locking loop within the right renal pelvis.
Final contrast injection was performed to confirm positioning.
The ileostomy bag was replaced. The patient tolerated the
procedure well, left the department in stable condition.
Impression:
Fluoroscopically guided exchange of a 10.2 French, 45 cm
nephrostomy for
new, 10.2 Fr, 45 cm long right retrograde transileal nephrostomy
as above.
How to code change of nephrostomy thro ileal conduit.My codes are
50690
74425-26
50688
75984-26
Please confirm.
Clinical history: 52 year old male with history of bladder cancer
status post cystectomy and creation of ileal conduit, who
subsequently developed a distal right ureteral stricture. The
patient is status post numerous, unsuccessful attempts at ureteral
dilatation. The patient has an indwelling retrograde right
percutaneous nephrostomy. Referred for routine exchange.
Moderate Sedation was provided using IV versed and fentanyl
10 cc of isovue 300 were used as contrast.
Technique:
The procedure was initially discussed with the patient at length,
including risks benefits and alternatives. Risks discussed
included but not were not limited to sepsis, bleeding, etc.. The
patient understood, asked appropriate questions and signed
informed consent.
The right lower quadrant, ileostomy, and existing drainage
catheter were prepped and draped in usual sterile manner.
Initially contrast injected into the catheter demonstrated the
catheter tip within the right renal pelvis. Minimal hydronephrosis
is visualized.
Using seldinger technique, the catheter was exchanged out over a
Amplatz super stiff wire, and a new, 10.2 French, 45 cm all
purpose
drainage catheter with locking loop was placed, positioned with
the tube with the up locking loop within the right renal pelvis.
Final contrast injection was performed to confirm positioning.
The ileostomy bag was replaced. The patient tolerated the
procedure well, left the department in stable condition.
Impression:
Fluoroscopically guided exchange of a 10.2 French, 45 cm
nephrostomy for
new, 10.2 Fr, 45 cm long right retrograde transileal nephrostomy
as above.