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Manometric studies through nephrostomy or pyelostomy tube, or indwelling ureteral catheter, commonly referred to as a Whitaker test, are diagnostic procedures used to assess the pressures within the renal pelvis and ureter. These studies are particularly important for evaluating persistent upper urinary tract dilatation, which may occur in patients who have previously undergone surgical interventions aimed at relieving obstructions in the upper urinary tract. The procedure is also utilized to determine the patency of an indwelling ureteral catheter, ensuring that the catheter is functioning properly and allowing for adequate drainage. During the procedure, a bladder catheter is inserted through the urethra, and the area surrounding an existing nephrostomy or pyelostomy tube is meticulously cleansed with an antibacterial solution to minimize the risk of infection. This careful preparation is crucial for the accuracy of the study and the safety of the patient. The procedure involves connecting the nephrostomy tube and bladder catheter to a pressure transducer to obtain baseline pressure readings, followed by the perfusion of saline or contrast solution into the kidney to measure serial pressures. The results of these studies provide valuable insights into the functionality of the urinary tract and guide further clinical decision-making.
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Manometric studies through nephrostomy or pyelostomy tube, or indwelling ureteral catheter are indicated for the following conditions:
The procedure for conducting manometric studies through nephrostomy or pyelostomy tube, or indwelling ureteral catheter involves several critical steps:
After the completion of the manometric studies, it is important to monitor the patient for any immediate complications or discomfort. The reconnected drainage bag should be checked for proper function to ensure that urine is draining adequately from the nephrostomy tube. Patients may be advised to maintain hydration and report any unusual symptoms, such as pain or changes in urinary output, to their healthcare provider. Follow-up appointments may be scheduled to discuss the results of the manometry studies and to determine any necessary further interventions based on the findings.
| Short Descr | MEASURE KIDNEY PRESSURE | Medium Descr | MANOMETRIC STDS THRU TUBE/NDWELLG URTRL CATH | Long Descr | Manometric studies through nephrostomy or pyelostomy tube, or indwelling ureteral catheter | 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 | Surgical procedure on ASC list in CY 2007; payment based on OPPS relative payment weight. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P5E - Ambulatory procedures - other | MUE | 1 | CCS Clinical Classification | 200 - Nonoperative urinary system measurements |
This is a primary code that can be used with these additional add-on codes.
| 74425 | Add-on Code MPFS Status: Active Code APC Q2 ASC N1 Physician Quality Reporting PUB 100 CPT Assistant Article Urography, antegrade, radiological supervision and interpretation |
| 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). | 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. | 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.) | 82 | Assistant surgeon (when qualified resident surgeon not available): the unavailability of a qualified resident surgeon is a prerequisite for use of modifier 82 appended to the usual procedure code number(s). | 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) |
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| Pre-1990 | Added | Code added. |
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