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Thread: Bilateral Nephrostomy,Bilateral Ureteral stent

  1. #1

    Default Bilateral Nephrostomy,Bilateral Ureteral stent

    AAPC: Back to School
    Hello All:
    How to code this senario.
    is this correct.
    1. Bilateral Nephrostomy placement
    2. Bilateral Ureteral stent placement.

    With the patient in prone position, both flanks were prepped and
    draped in the usual sterile manner and locally anesthetized with
    1% lidocaine. Initially, under real time ultrasound imaging
    guidance a left lower pole posterior calix was accessed with a
    21-gauge needle. An ultrasound imaged was recorded for the
    patient's record. Contrast was injected and a nephrostogram was
    obtained, confirming the calyceal puncture. The site was then
    dilated with a triaxial introducer set, and a been a 4-French
    Berenstein catheter was advanced into the distal ureter. Contrast
    is injected and multiple images were obtained. This demonstrates
    severe hydroureteronephrosis. The ureter is occluded at the
    region of the pelvic inlet.

    Using a Berenstein catheter and an angled Glidewire, the occluded
    ureter was successfully traversed, into the bladder. Over an
    Amplatz wire the tract was dilated and an 8-French double-J
    ureteral stent was deployed, positioned with the distal loop in
    the bladder and the proximal loop coiled within the renal pelvis.
    An 8-French nephrostomy catheter was left in place on the left as

    Using similar technique on the right side, a right-sided 8-French
    nephrostomy and 8-French 22 center long double-J ureteral stent
    were placed. The only difference on the right is that two- stick
    technique was used, as the first ultrasound-guided access was into
    an infundibulum. The second fluoroscopy guided access was
    directly into a posterior lower pole calix. On the right there
    was only moderate hydronephrosis, and the right ureter occludes
    higher up, in the lower abdomen.

    At the end of the procedure both nephrostomy catheters were
    sutured in place and connected to an external drainage bag and
    sterile dressings were applied. The patient tolerated the
    procedure well, left the department in stable condition.


    Bilateral 8-French 22 cm long ureteral stents placed, as well as
    bilateral 8-French nephrostomy catheters.
    Shirley CPC,CPC-H

  2. #2



    that's what I would do...

  3. #3


    Shirley CPC,CPC-H

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