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The procedure described by CPT® Code 50555 involves renal endoscopy performed through an already established nephrostomy or pyelostomy. This technique is utilized primarily to obtain a biopsy or to fulgurate, or destroy, lesions within the kidney. The process begins with the removal of the external drainage bag from the nephrostomy or pyelostomy tube, which is essential for accessing the kidney. A guidewire is then carefully advanced through the tube, allowing for the nephrostomy tube to be removed over the guidewire, ensuring that the tract remains open for further procedures. Following this, a series of dilators are utilized to expand the tract sufficiently to accommodate the insertion of a renal endoscope. Once the endoscope is in place, the kidney is meticulously examined. During this examination, sterile saline or another suitable solution may be used for irrigation purposes, and diagnostic or therapeutic solutions can be instilled into the kidney. Additionally, contrast material may be introduced for radiopyelography, which is a separate procedure that is not included in this code. After the examination, biopsy forceps are introduced through the endoscope to obtain one or more tissue samples from the kidney. This procedure is critical for diagnosing various renal conditions. Following the biopsy, all instruments are removed, the nephrostomy tube is replaced, and the external drainage bag is reattached, completing the procedure. This comprehensive approach allows for both diagnostic and therapeutic interventions within the renal system through a minimally invasive technique.
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The renal endoscopy procedure described by CPT® Code 50555 is indicated for various clinical scenarios, particularly when there is a need to obtain tissue samples from the kidney or to address specific lesions. The following conditions may warrant this procedure:
The procedural steps for CPT® Code 50555 are as follows:
Post-procedure care following CPT® Code 50555 involves monitoring the patient for any immediate complications related to the renal endoscopy. Patients may be observed for signs of bleeding, infection, or any adverse reactions to the anesthesia used during the procedure. It is essential to ensure that the nephrostomy tube remains patent and that the external drainage bag is functioning correctly. Patients may be advised on activity restrictions and signs to watch for that would necessitate immediate medical attention. Follow-up appointments may be scheduled to discuss biopsy results and any further management required based on the findings.
| Short Descr | KIDNEY ENDOSCOPY & BIOPSY | Medium Descr | RENAL NDSC NEPHROS/PYELOSTOMY BIOPSY | Long Descr | Renal endoscopy through established nephrostomy or pyelostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with biopsy | Status Code | Active Code | Global Days | 000 - Endoscopic or Minor Procedure | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 3 - Special payment adjustment rules for multiple endoscopic 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. | Endoscopic Base Code | 50551 Renal endoscopy through established nephrostomy or pyelostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; | 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 |
| 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). | 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. | 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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