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The procedure described by CPT® Code 50551 involves renal endoscopy performed through an already established nephrostomy or pyelostomy. This procedure is typically indicated for patients who require examination or treatment of the kidney via an existing drainage system. The nephrostomy or pyelostomy tube, which is used to drain urine directly from the kidney or renal pelvis, is utilized as the access point for the endoscopic procedure. The process begins with the removal of the external drainage bag from the nephrostomy or pyelostomy tube, allowing for direct access to the internal drainage system. A guidewire is then advanced through the tube, facilitating the removal of the nephrostomy tube itself over the guidewire. This step is crucial as it prepares the tract for further dilation. Subsequently, a series of dilators are introduced over the guidewire to expand the tract, enabling the safe insertion of the renal endoscope. Once the endoscope is in place, the kidney can be thoroughly examined for any abnormalities. During this procedure, sterile saline or other solutions may be used for irrigation purposes, and diagnostic or therapeutic solutions can be instilled into the kidney. Additionally, contrast material may be introduced for ureteropyelography, which is a separate reportable service. This procedure is essential for diagnosing and treating various renal conditions, ensuring that any obstructions or stenosis can be identified and addressed effectively. Overall, CPT® Code 50551 encompasses a critical intervention that leverages existing nephrostomy or pyelostomy access to facilitate renal examination and treatment.
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The procedure described by CPT® Code 50551 is indicated for various conditions related to the kidney and urinary tract. The following are the explicitly provided indications for performing renal endoscopy through an established nephrostomy or pyelostomy:
The procedure for CPT® Code 50551 involves several critical steps to ensure effective renal endoscopy through an established nephrostomy or pyelostomy:
Post-procedure care following the renal endoscopy through nephrostomy or pyelostomy involves monitoring the patient for any complications and ensuring the proper functioning of the nephrostomy tube. Patients may be observed for signs of infection, bleeding, or any adverse reactions to the solutions instilled during the procedure. It is essential to ensure that the nephrostomy tube remains patent and that urine is draining adequately. Follow-up imaging or assessments may be required to evaluate the success of the procedure and to monitor for any recurrence of issues such as obstruction or stenosis. Patients should be provided with instructions regarding care of the nephrostomy site and signs to report to their healthcare provider.
| Short Descr | KIDNEY ENDOSCOPY | Medium Descr | RENAL ENDOSCOPY NEPHROSTOMY W/WO IRRIGATION | Long Descr | Renal endoscopy through established nephrostomy or pyelostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; | 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) | P8I - Endoscopy - other | MUE | 1 | CCS Clinical Classification | 100 - Endoscopy and endoscopic biopsy of the urinary tract |
| 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). | RT | Right side (used to identify procedures performed on the right side of the body) | 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.) | 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) |
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| 2010-01-01 | Changed | Code description changed. |
| Pre-1990 | Added | Code added. |
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