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The CPT® Code 50606 refers to an endoluminal biopsy of the ureter and/or renal pelvis that is performed using non-endoscopic techniques. This procedure is typically conducted in conjunction with other genitourinary interventions. The biopsy is facilitated through a catheter that has been previously positioned, such as for a nephrostogram or ureterogram. The process involves the placement of a guidewire to explore the ureteropelvic junction, allowing access to the ureter. Once the area of interest is identified, the catheter is maneuvered past the lesion or stricture, and the guidewire remains in place as the catheter is withdrawn. A sheath is then advanced over the guidewire to the targeted area, followed by the introduction of a specialized brush biopsy catheter. This catheter is used to obtain multiple samples from the lesion through brushings. After the biopsy samples are collected, they are placed in a container for laboratory analysis. The procedure also includes all necessary imaging guidance, such as ultrasound or fluoroscopy, along with the associated radiological supervision and interpretation. It is important to note that this code is considered an add-on code, meaning it should be reported in addition to the primary procedure performed.
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The endoluminal biopsy of the ureter and/or renal pelvis, as described by CPT® Code 50606, is indicated for various clinical scenarios where tissue sampling is necessary. The following conditions may warrant this procedure:
The procedure for performing an endoluminal biopsy of the ureter and/or renal pelvis involves several critical steps, each designed to ensure accurate tissue sampling while minimizing patient risk. The following outlines the procedural steps:
Post-procedure care following an endoluminal biopsy of the ureter and/or renal pelvis typically involves monitoring the patient for any immediate complications, such as bleeding or infection. Patients may be advised to maintain hydration to facilitate urinary flow and help flush out any residual contrast material used during imaging. Follow-up appointments may be scheduled to discuss biopsy results and any further management based on the findings. It is essential for healthcare providers to provide clear instructions regarding signs of complications that patients should report, such as increased pain, fever, or changes in urinary output.
Short Descr | ENDOLUMINAL BX URTR RNL PLVS | Medium Descr | ENDOLUMINAL BX URTR &/RNL PELVIS NONENDOSCOPIC | Long Descr | Endoluminal biopsy of ureter and/or renal pelvis, non-endoscopic, including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation (List separately in addition to code for primary procedure) | Status Code | Active Code | Global Days | ZZZ - Code Related to Another Service | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 0 - No 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 | Items and Services Packaged into APC Rates | ASC Payment Indicator | Packaged service/item; no separate payment made. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P5E - Ambulatory procedures - other | MUE | 1 |
This is an add-on code that must be used in conjunction with one of these primary codes.
50382 | MPFS Status: Active Code APC J1 ASC G2 Physician Quality Reporting CPT Assistant Article Removal (via snare/capture) and replacement of internally dwelling ureteral stent via percutaneous approach, including radiological supervision and interpretation | 50384 | MPFS Status: Active Code APC Q2 ASC G2 Physician Quality Reporting CPT Assistant Article Removal (via snare/capture) of internally dwelling ureteral stent via percutaneous approach, including radiological supervision and interpretation | 50385 | MPFS Status: Active Code APC J1 ASC G2 Physician Quality Reporting PUB 100 CPT Assistant Article Removal (via snare/capture) and replacement of internally dwelling ureteral stent via transurethral approach, without use of cystoscopy, including radiological supervision and interpretation | 50386 | MPFS Status: Active Code APC Q2 ASC P3 Physician Quality Reporting PUB 100 CPT Assistant Article Removal (via snare/capture) of internally dwelling ureteral stent via transurethral approach, without use of cystoscopy, including radiological supervision and interpretation | 50387 | MPFS Status: Active Code APC J1 ASC G2 Physician Quality Reporting CPT Assistant Article Removal and replacement of externally accessible nephroureteral catheter (eg, external/internal stent) requiring fluoroscopic guidance, including radiological supervision and interpretation | 50389 | MPFS Status: Active Code APC Q2 ASC G2 Physician Quality Reporting CPT Assistant Article Removal of nephrostomy tube, requiring fluoroscopic guidance (eg, with concurrent indwelling ureteral stent) | 50430 | Resequenced Code MPFS Status: Active Code APC Q2 ASC N1 Injection procedure for antegrade nephrostogram and/or ureterogram, complete diagnostic procedure including imaging guidance (eg, ultrasound and fluoroscopy) and all associated radiological supervision and interpretation; new access | 50431 | Resequenced Code MPFS Status: Active Code APC Q2 ASC N1 Injection procedure for antegrade nephrostogram and/or ureterogram, complete diagnostic procedure including imaging guidance (eg, ultrasound and fluoroscopy) and all associated radiological supervision and interpretation; existing access | 50432 | Resequenced Code MPFS Status: Active Code APC J1 ASC G2 Placement of nephrostomy catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation | 50433 | Resequenced Code MPFS Status: Active Code APC J1 ASC G2 Placement of nephroureteral catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation, new access | 50434 | Resequenced Code MPFS Status: Active Code APC J1 ASC G2 Convert nephrostomy catheter to nephroureteral catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation, via pre-existing nephrostomy tract | 50435 | Resequenced Code MPFS Status: Active Code APC J1 ASC G2 Exchange nephrostomy catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation | 50684 | MPFS Status: Active Code APC N ASC N1 Injection procedure for ureterography or ureteropyelography through ureterostomy or indwelling ureteral catheter | 50688 | MPFS Status: Active Code APC J1 ASC A2 Change of ureterostomy tube or externally accessible ureteral stent via ileal conduit | 50690 | MPFS Status: Active Code APC N ASC N1 Injection procedure for visualization of ileal conduit and/or ureteropyelography, exclusive of radiologic service | 50693 | MPFS Status: Active Code APC J1 ASC G2 Placement of ureteral stent, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological supervision and interpretation; pre-existing nephrostomy tract | 50694 | MPFS Status: Active Code APC J1 ASC G2 Placement of ureteral stent, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological supervision and interpretation; new access, without separate nephrostomy catheter | 50695 | MPFS Status: Active Code APC J1 ASC G2 Placement of ureteral stent, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological supervision and interpretation; new access, with separate nephrostomy catheter | 51610 | MPFS Status: Active Code APC N ASC N1 Injection procedure for retrograde urethrocystography |
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). | CR | Catastrophe/disaster related | 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) | 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 | 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 | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure |
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2017-01-01 | Changed | Moderate (Conscious) Sedation flag removed. See new Moderate Sedation category. |
2016-01-01 | Added | Added |