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Thread: Neprostomy thro' ileal conduit

  1. #1

    Default Neprostomy thro' ileal conduit

    AAPC: Back to School

    How to code change of nephrostomy thro ileal conduit.My codes are
    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.

    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
    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.


    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.
    Shirley CPC,CPC-H

  2. #2

    Default Neprostomy thro' ileal conduit

    You are Correct!!

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