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Official Description

Removal (via snare/capture) of internally dwelling ureteral stent via percutaneous approach, including radiological supervision and interpretation

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

The procedure described by CPT® Code 50384 involves the removal of an indwelling ureteral stent through a percutaneous approach, utilizing radiological supervision and interpretation. This procedure is typically performed when a ureteral stent, which is a tube placed in the ureter to facilitate urine flow from the kidney to the bladder, needs to be removed. The stent may be removed due to various reasons, including obstruction, infection, or the completion of a treatment course. The percutaneous approach means that the procedure is conducted through the skin, minimizing the need for larger incisions and allowing for a less invasive technique. The use of radiographic guidance is crucial in this procedure, as it ensures accurate placement and removal of the stent while visualizing the kidney and ureter. This method enhances the safety and effectiveness of the procedure, allowing the physician to navigate the anatomy precisely and confirm the correct positioning of the stent during removal and replacement.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

The procedure described by CPT® Code 50384 is indicated for the removal of an indwelling ureteral stent in various clinical scenarios. The following conditions may warrant this procedure:

  • Obstruction: The stent may be obstructed or blocked, necessitating its removal to restore normal urine flow.
  • Infection: The presence of infection in the urinary tract may require the removal of the stent to address the underlying issue.
  • Completion of Treatment: The stent may have been placed as part of a treatment plan, and its removal is necessary upon completion of the intended therapy.
  • Stent Dysfunction: If the stent is not functioning as intended, removal is indicated to prevent complications.

2. Procedure

The procedure for the removal of an indwelling ureteral stent via CPT® Code 50384 involves several detailed steps:

  • Step 1: A small skin incision is made over the selected entry site in the kidney. This incision allows access to the renal calyx, where the stent is located.
  • Step 2: A needle is inserted into the renal calyx and positioned accurately using radiographic guidance. This step is crucial for ensuring that the needle is correctly placed to access the stent.
  • Step 3: Contrast media is injected through the needle, and fluoroscopy is performed to visualize the kidney and ureter. This imaging technique helps confirm the anatomy and the position of the stent.
  • Step 4: A guidewire is introduced into the renal pelvis, allowing for the subsequent steps to be performed safely. The needle is then removed, and the tract is dilated to facilitate the passage of instruments.
  • Step 5: A sheath is placed over the guidewire and advanced into the renal pelvis. This sheath serves as a conduit for the snare device.
  • Step 6: A snare device is passed through the renal pelvis and into the ureter to capture the indwelling stent. This step is critical for securely grasping the stent for removal.
  • Step 7: The stent is retracted until the proximal end is exposed, allowing for easier manipulation and removal.
  • Step 8: A guidewire is placed through the partially externalized stent and positioned in the ureter. This ensures that the ureter remains patent during the removal process.
  • Step 9: The stent is then removed, leaving the guidewire in place to maintain access to the ureter.
  • Step 10: A replacement stent is advanced over the guidewire, with the distal end positioned in the bladder. This step is essential for ensuring continued urine flow post-removal.
  • Step 11: The correct positioning of the replacement stent is verified radiographically, confirming that it is placed correctly within the urinary tract.
  • Step 12: All surgical instruments are removed, and a final set of radiographs is obtained to document the correct positioning of the stent, ensuring that the procedure has been completed successfully.

3. Post-Procedure

After the procedure, patients may require monitoring for any immediate complications, such as bleeding or infection. It is essential to ensure that the replacement stent is functioning correctly and that there are no signs of obstruction. Patients may be advised to follow up with their healthcare provider for further evaluation and management. Additionally, instructions regarding activity restrictions, hydration, and signs of complications should be provided to ensure a smooth recovery process.

Short Descr REMOVE URETER STENT PERCUT
Medium Descr REMOVAL INDWELLING URETERAL STENT PRQ
Long Descr Removal (via snare/capture) of internally dwelling ureteral stent via percutaneous approach, including radiological supervision and interpretation
Status Code Active Code
Global Days 000 - Endoscopic or Minor Procedure
PC/TC Indicator (26, TC) 0 - Physician Service Code
Multiple Procedures (51) 2 - Standard payment adjustment rules for multiple procedures apply.
Bilateral Surgery (50) 1 - 150% payment adjustment for bilateral procedures applies.
Physician Supervisions 09 - Concept does not apply.
Assistant Surgeon (80, 82) 1 - Statutory payment restriction for assistants at surgery applies to this procedure...
Co-Surgeons (62) 0 - Co-surgeons not permitted for this procedure.
Team Surgery (66) 0 - Team surgeons not permitted for this procedure.
Diagnostic Imaging Family 99 - Concept Does Not Apply
APC Status Indicator T-Packaged Codes
ASC Payment Indicator Non office-based surgical procedure added in CY 2008 or later; payment based on OPPS relative payment weight.
Type of Service (TOS) 2 - Surgery
Berenson-Eggers TOS (BETOS) P6C - Minor procedures - other (Medicare fee schedule)
MUE 1
CCS Clinical Classification 111 - Other non-OR therapeutic procedures of urinary tract

This is a primary code that can be used with these additional add-on codes.

50606 Addon Code MPFS Status: Active Code APC N ASC N1 Endoluminal biopsy of ureter and/or renal pelvis, non-endoscopic, including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation (List separately in addition to code for primary procedure)
50705 Addon Code MPFS Status: Active Code APC N ASC N1 Ureteral embolization or occlusion, including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation (List separately in addition to code for primary procedure)
50706 Addon Code MPFS Status: Active Code APC N ASC N1 Balloon dilation, ureteral stricture, including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation (List separately in addition to code for primary procedure)
22 Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service.
50 Bilateral procedure: unless otherwise identified in the listings, bilateral procedures that are performed at the same session, should be identified by adding modifier 50 to the appropriate 5 digit code. note: this modifier should not be appended to designated "add-on" codes (see appendix d).
51 Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d).
52 Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well-being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use).
53 Discontinued procedure: under certain circumstances, the physician or other qualified health care professional may elect to terminate a surgical or diagnostic procedure. due to extenuating circumstances or those that threaten the well being of the patient, it may be necessary to indicate that a surgical or diagnostic procedure was started but discontinued. this circumstance may be reported by adding modifier 53 to the code reported by the individual for the discontinued procedure. note: this modifier is not used to report the elective cancellation of a procedure prior to the patient's anesthesia induction and/or surgical preparation in the operating suite. for outpatient hospital/ambulatory surgery center (asc) reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use).
58 Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78.
59 Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25.
78 Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.)
79 Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.)
GC This service has been performed in part by a resident under the direction of a teaching physician
GW Service not related to the hospice patient's terminal condition
LT Left side (used to identify procedures performed on the left side of the body)
RT Right side (used to identify procedures performed on the right side of the body)
X4 Episodic/focused services: for reporting services by clinicians who provide focused care on particular types of treatment limited to a defined period and circumstance; the patient has a problem, acute or chronic, that will be treated with surgery, radiation, or some other type of generally time-limited intervention; reporting clinician service examples include but are not limited to, the orthopedic surgeon performing a knee replacement and seeing the patient through the postoperative period
X5 Diagnostic services requested by another clinician: for reporting services by a clinician who furnishes care to the patient only as requested by another clinician or subsequent and related services requested by another clinician; this modifier is reported for patient relationships that may not be adequately captured by the above alternative categories; reporting clinician service examples include but are not limited to, the radiologist's interpretation of an imaging study requested by another clinician
XS Separate structure, a service that is distinct because it was performed on a separate organ/structure
XU Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service
Date
Action
Notes
2017-01-01 Changed Moderate (Conscious) Sedation flag removed. See new Moderate Sedation category.
2011-01-01 Changed Short description changed.
2006-01-01 Added First appearance in code book in 2006.
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