Wiki Op note help, lower pole UPJ stone

sxcoder1

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Procedure performed: Antegrade and retrograde nephrostomy and wire endoscopic manipulation with demonstration of lower pole ureter meatus intra ureterally with ureteral dilatation ureteroscopy both flexible and rigid litholapaxy and placement of indwelling retrograde stent

Procedure: Following satisfactory anesthesia patient placed dorsolithotomy position. Introitus and vagina were prepped with Betadine solution daily draped. 21 French scope inserted the previous nephrostomy a sensor wire was passed except from the external orifice of it through the bladder cystoscopy was performed and the wire grasped and brought out the urethral meatus. With the wire through and through the nephrostomy tube was advanced out so that there was no nephrostomy tube and the patient over the ureteral wire ureteral access sheaths were utilized to dilate the ureter. Ureteroscopy performed with the rigid scope showed the lower pole moiety to be coming off inside the intramural ureter at approximately the 1 o'clock position. This was dilated to 14 French a ureteroscope introduced but could not make the curve from the obstructed lower pole moiety. Therefore the flexible scope was introduced and attempts were made to break the stone I was able to chip open the area near the wire. Next the rigid scope was reintroduced and the stone was again fractured with the lithotriptor laser. At this point it became bloody urine visualization was poor fearing possible damage to the ureter it was elected to advance the wire and through manipulation antegrade and post and retrograde I was able to place retrograde a softer ureteral stent 24 French centimeter. Its position was affirmed by fluoroscopy bladder drained patient taken recovery room in satisfactory condition.

I can't understand this op note, does it make sense to anyone else? I can ask the doctor, but I'm not really sure what to ask him. I do know that the patient had a left nephrostomy tube. Does this seem like 52356?

Thank you for any help!
 
The documentation isn't very clear and almost sounds like the physician dictated it but didn't go back to edit it. But 52356 isn't correct here because the approach was not transurethral. I think the correct code here is probably going to be 50080 or 50081 depending on the size of the stone.
 
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