Wiki RT NEPHROLITHOTOMY PERCUTANEOUS, URETEROSCOPY ANTEGRADE WITH DILATION OF STRICTURE AT ANASTOMOSIS, RT STENT AND NEPHROSTOMY TUBE

sxcoder1

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Surgical Technique: After informed consent and adequate anesthesia patient was placed in a prone position back and flank were prepped with Betadine solution sterilely draped. Examination of fluoroscopy showed to be glue in the area of the pelvis and the tubing was cut cutting the stitch to the loop to open loop up through this wire through this a wire was passed down into the bladder a Amplatz could not be passed due to the curvature but a sensor wire was passed. Next the Amplatz dilators were utilized first with the and internal sheath giving some firmness to the wire and then subsequent dilators utilized at the point of approximately 8 French and a second wire was passed down the I was then able to to place the flexible cystoscope through a 24 nephrostomy site examination showed some tears in the pelvis and the wire and I was only able to follow the wires part way due to the size of the ureter. In view of this a flexible ureteroscope was utilized I was able to get all the way down to a fibrotic area in the distal ureter a second Amplatz was passed and over this dilator was passed to dilate this stricture I was then able to get the ureteroscope into the bladder this was confirmed with contrast. Over this wire a 24 cm 6 French double-J was left in place a nephrostomy tube placed through the flank and position affirmed by fluoroscopy and antegrade nephrogram this was sutured to the skin.

I don't see any stone removal, am I correct that this would be 50693? And would I code 50706 for dilation of ureter? Thank you for any help!
 
The operative report is not well dictated and confusing, but
I believe 50693 and 50706 would appear to be correct. Also add 50435 for nephrostomy tube re-placement.
 
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