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The procedure described by CPT® Code 50592 involves the ablation of one or more renal tumors located in either the right or left kidney through a percutaneous approach utilizing radiofrequency technology. Ablation refers to the process of destroying tumor tissue, and in this case, it is achieved by applying electrical currents that generate heat. This heat effectively destroys the tumor cells while simultaneously cauterizing surrounding blood vessels, which minimizes the risk of bleeding during the procedure. The technique is performed under imaging guidance, such as ultrasound, CT, or MRI, to accurately locate the tumor and ensure precise placement of the electrode needle. Grounding pads are strategically placed on the patient's back and thighs to facilitate the safe delivery of radiofrequency energy. The procedure is carefully executed to avoid damage to adjacent organs and major blood vessels, ensuring patient safety throughout the process. The use of continuous imaging allows for real-time monitoring of the needle's position and the effectiveness of the tumor destruction, making it a targeted and minimally invasive treatment option for renal tumors.
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The procedure is indicated for the treatment of renal tumors, which may include the following conditions:
The ablation procedure begins with the identification of the renal tumor using imaging techniques such as ultrasound, CT, or MRI. This imaging guidance is crucial for accurately locating the tumor and determining the optimal track for the electrode needle. Once the tumor is located, grounding pads are placed on the patient's back and thighs to ensure safety during the procedure. The physician then inserts the electrode needle through the skin and into the tumor, utilizing continuous imaging guidance to navigate the needle's path carefully. This step is critical to avoid any damage to surrounding organs and major blood vessels. After confirming the correct placement of the needle tip, the electrode is connected to a radiofrequency generator. The generator is activated, delivering electrical currents that produce heat around the needle, effectively destroying the tumor tissue. Throughout the procedure, imaging guidance is employed to monitor the progress of tumor destruction. In cases where multiple or particularly large tumors are present, the physician may use more than one needle or may partially withdraw and reposition the needle after each application of radiofrequency energy to ensure comprehensive treatment. Upon completion of the ablation, the needle is withdrawn, and pressure is applied to the insertion site to prevent any bleeding along the needle track.
After the ablation procedure, patients are typically monitored for any immediate complications, such as bleeding or infection. It is essential to apply pressure to the needle insertion site to minimize the risk of bleeding. Patients may experience some discomfort or pain at the site of the procedure, which can be managed with appropriate pain relief measures. Follow-up imaging may be required to assess the effectiveness of the ablation and to ensure that the tumor has been adequately treated. Patients should be advised on signs of complications, such as increased pain, fever, or changes in urinary habits, and instructed to seek medical attention if these occur. Overall, the recovery process may vary depending on the individual patient's health status and the extent of the procedure performed.
| Short Descr | PERC RF ABLATE RENAL TUMOR | Medium Descr | ABLTJ 1/> RENAL TUMOR PRQ UNI RADIOFREQUENCY | Long Descr | Ablation, 1 or more renal tumor(s), percutaneous, unilateral, radiofrequency | Status Code | Active Code | Global Days | 010 - 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) | 1 - Statutory 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 | 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) | P6C - Minor procedures - other (Medicare fee schedule) | MUE | 1 | CCS Clinical Classification | 111 - Other non-OR therapeutic procedures of urinary tract |
| 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) | GC | This service has been performed in part by a resident under the direction of a teaching physician | X4 | Episodic/focused services: for reporting services by clinicians who provide focused care on particular types of treatment limited to a defined period and circumstance; the patient has a problem, acute or chronic, that will be treated with surgery, radiation, or some other type of generally time-limited intervention; reporting clinician service examples include but are not limited to, the orthopedic surgeon performing a knee replacement and seeing the patient through the postoperative period | 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). | 53 | Discontinued procedure: under certain circumstances, the physician or other qualified health care professional may elect to terminate a surgical or diagnostic procedure. due to extenuating circumstances or those that threaten the well being of the patient, it may be necessary to indicate that a surgical or diagnostic procedure was started but discontinued. this circumstance may be reported by adding modifier 53 to the code reported by the individual for the discontinued procedure. note: this modifier is not used to report the elective cancellation of a procedure prior to the patient's anesthesia induction and/or surgical preparation in the operating suite. for outpatient hospital/ambulatory surgery center (asc) reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use). | 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. | 76 | Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | 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.) | AG | Primary physician | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | MG | The order for this service does not have applicable appropriate use criteria in the qualified clinical decision support mechanism consulted by the ordering professional | X5 | Diagnostic services requested by another clinician: for reporting services by a clinician who furnishes care to the patient only as requested by another clinician or subsequent and related services requested by another clinician; this modifier is reported for patient relationships that may not be adequately captured by the above alternative categories; reporting clinician service examples include but are not limited to, the radiologist's interpretation of an imaging study requested by another clinician |
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| 2017-01-01 | Changed | Moderate (Conscious) Sedation flag removed. See new Moderate Sedation category. |
| 2009-01-01 | Changed | Code description changed. |
| 2006-01-01 | Added | First appearance in code book in 2006. |
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