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The procedure described by CPT® Code 50580 involves a renal endoscopy performed through a nephrotomy or pyelotomy, which are surgical incisions made in the kidney. This procedure is utilized to examine the internal structures of the kidney using a specialized instrument known as a renal endoscope. During the procedure, the surgeon makes a small incision to access the kidney, allowing for direct visualization and intervention. The primary goal is to locate and remove foreign bodies or calculi (stones) that may be obstructing the urinary tract or causing other complications. The use of sterile saline or other solutions for irrigation is common, as it helps to clear the area and facilitate the examination. Additionally, a diagnostic or therapeutic solution may be instilled into the kidney to aid in treatment, and contrast material may be used for ureteropyelography, which is a separate radiologic service not included in this code. The procedure concludes with the careful removal of all instruments, inspection of the renal pelvis and calyces to ensure complete removal of any fragments, and closure of the incision, with the potential placement of a nephrostomy tube if necessary for drainage. This comprehensive approach ensures that the kidney is thoroughly examined and treated, minimizing the risk of complications and promoting recovery.
© Copyright 2025 Coding Ahead. All rights reserved.
The procedure described by CPT® Code 50580 is indicated for the following conditions:
The procedure begins with the patient positioned appropriately to allow access to the kidney. An incision is made in the kidney, either through nephrotomy or pyelotomy, to create an entry point for the renal endoscope. Once the incision is made, the renal endoscope is carefully inserted into the kidney. This instrument allows the surgeon to visualize the internal structures of the kidney, including the renal pelvis and calyces. During this examination, the surgeon looks for the presence of any foreign bodies or calculi. If a foreign body or calculus is identified, sterile saline or another irrigation solution may be used to flush the area, which helps to clear debris and improve visibility. In some cases, a diagnostic or therapeutic solution may be instilled into the kidney to assist in treatment. If ureteropyelography is required, contrast material may be instilled for imaging purposes, but this service is not included in the CPT® code. After locating the foreign body or calculus, an endograsper is introduced through the nephroscope. The surgeon uses this tool to grasp the foreign body or calculus securely. Once it is grasped, the foreign body or calculus is carefully removed through the endoscope. Following the removal, the renal pelvis and calyces are inspected again to ensure that all fragments have been successfully extracted. After confirming that the area is clear, all instruments are removed from the kidney. If necessary, a nephrostomy tube may be placed to facilitate drainage, and the incision is then closed to complete the procedure.
Post-procedure care involves monitoring the patient for any signs of complications, such as infection or bleeding. The nephrostomy tube, if placed, will require care and monitoring to ensure proper drainage. Patients may be advised to follow specific instructions regarding activity levels and fluid intake to promote recovery. Follow-up appointments may be scheduled to assess kidney function and ensure that no residual stones or foreign bodies remain. Pain management may also be addressed as part of the post-operative care plan.
| Short Descr | KIDNEY ENDOSCOPY & TREATMENT | Medium Descr | RNL NDSC NFROT/PLOT W/RMVL FB/CALCULUS | Long Descr | Renal endoscopy through nephrotomy or pyelotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with removal of foreign body or calculus | 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 | 50570 Renal endoscopy through nephrotomy or pyelotomy, 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 | 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 | 101 - Transurethral excision, drainage, or removal urinary obstruction |
| 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. | 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. | 80 | Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure 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) |
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| Pre-1990 | Added | Code added. |
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