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The procedure described by CPT® Code 50562 involves a renal endoscopy performed through an already established nephrostomy or pyelostomy. This procedure is specifically designed for the examination and treatment of tumors located within the kidney. The process begins with the removal of the external drainage bag from the nephrostomy or pyelostomy tube, which is a tube inserted to allow urine to drain from the kidney. A guidewire is then advanced through this tube, facilitating the removal of the tube itself. Following this, a series of dilators are utilized to expand the tract, enabling the insertion of a renal endoscope. This endoscope allows for direct visualization of the kidney, where the physician can locate the tumor. During the procedure, sterile saline or other solutions may be used for irrigation, and diagnostic or therapeutic solutions can be instilled into the kidney. Additionally, contrast material may be introduced for ureteropyelography, which is a separate radiologic service that is not included in this code. Once the tumor is identified, the nephroscope is exchanged for a resectoscope, which is specifically designed for the resection of tissue. The tumor is then carefully resected and removed, with the use of irrigation and an endoscopic evacuation device to manage the surgical site. After the tumor has been excised, the kidney is re-examined to confirm the complete removal of the tumor, and any bleeding is controlled through a process known as fulguration. Finally, the resectoscope is removed, the nephrostomy tube is replaced, and the external drainage bag is reattached, ensuring that the kidney continues to drain properly post-procedure.
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The renal endoscopy procedure described by CPT® Code 50562 is indicated for the following conditions:
The procedure involves several critical steps to ensure effective examination and treatment of the renal tumor:
Post-procedure care involves monitoring the patient for any complications, ensuring that the nephrostomy tube is functioning correctly, and managing any discomfort or pain. Patients may require follow-up imaging to assess the success of the tumor resection and to monitor for any recurrence. It is essential to provide instructions regarding the care of the nephrostomy site and to schedule follow-up appointments for ongoing evaluation.
| Short Descr | RENAL SCOPE W/TUMOR RESECT | Medium Descr | RENAL NDSC NEPHROS/PYELOSTOMY RESCJ TUMOR | Long Descr | Renal endoscopy through established nephrostomy or pyelostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with resection of tumor | Status Code | Active Code | Global Days | 090 - Major Surgery | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 2 - Standard payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 2 - Payment restriction for assistants at surgery does not apply to this procedure... | Co-Surgeons (62) | 1 - Co-surgeons could be paid, though supporting documentation is required... | 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) | P8I - Endoscopy - other | MUE | 1 | CCS Clinical Classification | 112 - Other OR therapeutic procedures of 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). | 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). | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | 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) | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
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| 2003-01-01 | Added | First appearance in code book in 2003. |
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