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50390-74, 74425 or 76000

  1. Default 50390-74, 74425 or 76000
    Medical Coding Books
    Would you bill this as reduced 50390-74, 74425 or 76000? I thought if there was a lesser service that was billable I should choose that???? Thanks! Sue



    Ultrasound and fluoroscopic guided left antegrade nephrostogram attempt.

    History: Obstructing left ureteral stone for left PCN placement. Third trimester pregnancy. Transfer from Women's and Babies Hospital for left PCN placement.

    Technique: Written informed consent was obtained. Patient placed in the right lateral decubitus position and skin over the left flank prepped and draped sterilely. 2% lidocaine used as local anesthetic. Moderate sedation also administered. Ultrasound was used to determine potential access sites and for real-time guidance into the left kidney. Antegrade nephrostograms were attempted but were not successful. No complications occurred.

    Findings: Comparison with diagnostic renal ultrasound 26 September 2014.

    Hydronephrosis has essentially resolved. Minimal pelvocaliectasis may be present. Antegrade nephrostogram could not be performed. Collecting system could not be accessed percutaneously. Patient tolerated the procedure well.

  2. #2
    Default
    Quote Originally Posted by suela923@aol.com View Post
    Would you bill this as reduced 50390-74, 74425 or 76000? I thought if there was a lesser service that was billable I should choose that???? Thanks! Sue



    Ultrasound and fluoroscopic guided left antegrade nephrostogram attempt.

    History: Obstructing left ureteral stone for left PCN placement. Third trimester pregnancy. Transfer from Women's and Babies Hospital for left PCN placement.

    Technique: Written informed consent was obtained. Patient placed in the right lateral decubitus position and skin over the left flank prepped and draped sterilely. 2% lidocaine used as local anesthetic. Moderate sedation also administered. Ultrasound was used to determine potential access sites and for real-time guidance into the left kidney. Antegrade nephrostograms were attempted but were not successful. No complications occurred.

    Findings: Comparison with diagnostic renal ultrasound 26 September 2014.

    Hydronephrosis has essentially resolved. Minimal pelvocaliectasis may be present. Antegrade nephrostogram could not be performed. Collecting system could not be accessed percutaneously. Patient tolerated the procedure well.
    I would do 74425-74. Fluoro is bundled in the charge.
    Thanks,
    Jim Pawloski, CIRCC

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