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The procedure described by CPT® Code 50385 involves the removal and replacement of an internally dwelling ureteral stent using a transurethral approach, specifically without the use of cystoscopy. An internally dwelling ureteral stent is a medical device designed to maintain the patency of the ureter, which is the tube that carries urine from the kidney to the bladder. This stent is typically a soft, hollow tube, approximately the size of a strand of spaghetti, and is utilized in cases where there is an obstruction or blockage that prevents normal urine flow. The stent is usually left in place temporarily, often for a duration ranging from a few weeks to several months, until the underlying obstruction is resolved. During the procedure, a catheter is inserted into the bladder, and a contrast agent is injected to enhance visualization of the ureter and stent under fluoroscopic guidance. A guidewire is then advanced into the bladder, and the initial catheter is replaced with a larger one to facilitate the removal of the stent. A snare or capture device is introduced to grasp the distal pigtail portion of the stent, allowing it to be pulled into the bladder and urethra for removal. Following the removal of the old stent, a new stent is positioned appropriately within the ureter, ensuring that the proximal pigtail is located in the renal pelvis and the distal pigtail is situated in the bladder. The correct placement of the new stent is confirmed through fluoroscopy and X-ray imaging, which documents the successful completion of the procedure. This comprehensive approach ensures that the ureter remains open, allowing for the proper drainage of urine and alleviating any obstructions present.
© Copyright 2025 Coding Ahead. All rights reserved.
The procedure described by CPT® Code 50385 is indicated for patients experiencing ureteral obstruction or blockage that necessitates the placement of a ureteral stent. The following conditions may warrant this procedure:
The procedure for the removal and replacement of an internally dwelling ureteral stent via a transurethral approach involves several detailed steps:
After the completion of the procedure, patients may require monitoring for any immediate complications, such as bleeding or infection. It is essential to ensure that the newly placed stent is functioning correctly and that urine is draining appropriately from the kidney to the bladder. Patients may be advised to follow up with their healthcare provider for imaging studies to confirm the stent's position and function. Additionally, instructions regarding activity restrictions, hydration, and signs of potential complications should be provided to ensure a smooth recovery process.
| Short Descr | CHANGE STENT VIA TRANSURETH | Medium Descr | REMOVE & REPLACE INDWELL URETERAL STENT TRURTHRL | Long Descr | Removal (via snare/capture) and replacement of internally dwelling ureteral stent via transurethral approach, without use of cystoscopy, 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) | 0 - 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 | Hospital Part B services paid through a comprehensive APC | 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) | P1G - Major procedure - Other | 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) |
| 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). | 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.) | 99 | Multiple modifiers: under certain circumstances 2 or more modifiers may be necessary to completely delineate a service. in such situations modifier 99 should be added to the basic procedure, and other applicable modifiers may be listed as part of the description of the service. | CR | Catastrophe/disaster related | GC | This service has been performed in part by a resident under the direction of a teaching physician | 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 |
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| 2017-01-01 | Changed | Moderate (Conscious) Sedation flag removed. See new Moderate Sedation category. |
| 2013-01-01 | Changed | Medium Descriptor changed. |
| 2008-01-01 | Added | First appearance in code book in 2008. |
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