Wiki retrograde Pyelogram

[holnkevin]

should we be charging for the pyelogram for this note, would that be 74420?

A 22 French rigid cystoscope was introduced into the patient's bladder and cystoscopy was performed with the below findings. A 6 French open ended catheter was cannulated in the right ureteral orifice without difficulty. A right retrograde pyelogram was performed with the below findings. A sensor wire was advanced into the right kidney under fluoroscopic guidance. A 6 French by variable length Cook ureteral stent with the string removed was placed in the right kidney with good proximal distal curls on fluoroscopy. A notable amount of purulent drainage emanated from the ureter as well as the right UVJ J stone was dislodged and sent for analysis. The patient's bladder was irrigated and drained. Patient was placed in the supine position awoken general anesthesia and brought to the PACU in good condition.

Findings:
Normal bladder mucosa
Bilateral orthotopic ureteral orifices
Right retrograde pyelogram with filling defect in proximal ureter
Dislodgment of right UVJ stone into the bladder
Successful placement of a 6 French by variable length Cook ureteral stent without a string on the right side
Copious purulent drainage from the right ureter

 

[daniel]

I'd query the doctor to state they injected contrast for the Retrograde pyelogram. This documentation is miss leading, A 6 French open ended catheter was cannulated in the right ureteral orifice without difficulty. A right retrograde pyelogram was performed with the below findings. A sensor wire was advanced into the right kidney under fluoroscopic guidance.
At first he states he placed a open ended catheter into the ureteral orifice. this would lead one to think this is where they injection contrast for 74420.26. but then then he switches up to fluoroscopic guidance. Which is not RETROGRADE.