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Official Description

Injection procedure for ureterography or ureteropyelography through ureterostomy or indwelling ureteral catheter

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

An injection procedure for ureterography or ureteropyelography is a specialized medical technique used to visualize the ureter and renal pelvis. This procedure is conducted through a ureterostomy, which is a surgical opening created in the abdominal wall to allow urine to exit the body, or through an indwelling ureteral catheter, which is a tube that has been placed in the ureter to facilitate urine drainage. During the procedure, a catheter is carefully inserted through the stoma in the skin into the ureter or through the existing indwelling ureteral catheter. Once the catheter is in place, radiographic contrast media, which is a substance that enhances the visibility of internal structures during imaging, is injected through the catheter. This contrast media allows for clear imaging of the ureter and renal pelvis on radiographs. After the injection, radiographs are obtained to assess the anatomy and any potential abnormalities in the ureter and renal pelvis. It is important to note that the radiographs obtained following the injection procedure are reported separately, ensuring accurate documentation and billing for the services rendered.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

The injection procedure for ureterography or ureteropyelography is indicated for various clinical scenarios where visualization of the ureter and renal pelvis is necessary. The following conditions may warrant this procedure:

  • Ureteral Obstruction: This procedure is performed to identify any blockages within the ureter that may impede the flow of urine.
  • Ureteral Stones: It is indicated for the detection and assessment of calculi (stones) located in the ureter or renal pelvis.
  • Ureteral Injury: The procedure may be necessary to evaluate any trauma or injury to the ureter.
  • Renal Pelvic Abnormalities: It is used to visualize and assess any structural abnormalities in the renal pelvis.
  • Preoperative Assessment: This procedure can be part of the preoperative evaluation for surgical interventions involving the urinary tract.

2. Procedure

The injection procedure for ureterography or ureteropyelography involves several critical steps to ensure accurate visualization of the ureter and renal pelvis. The following procedural steps are typically followed:

  • Step 1: Preparation of the Patient The patient is positioned appropriately, and the area around the stoma or indwelling catheter is cleaned and sterilized to minimize the risk of infection. The healthcare provider explains the procedure to the patient, ensuring informed consent is obtained.
  • Step 2: Catheter Placement A catheter is inserted through the stoma in the skin into the ureter or through the existing indwelling ureteral catheter. This step is crucial as it allows for the introduction of the contrast media directly into the urinary system.
  • Step 3: Injection of Contrast Media Once the catheter is securely in place, radiographic contrast media is injected through the catheter. This media enhances the visibility of the ureter and renal pelvis during imaging.
  • Step 4: Radiographic Imaging Following the injection of the contrast media, radiographs of the ureter and renal pelvis are obtained. These images are essential for diagnosing any abnormalities or conditions affecting the urinary tract.

3. Post-Procedure

After the injection procedure, the patient is monitored for any immediate complications or adverse reactions to the contrast media. It is important to assess the patient’s vital signs and ensure that they are stable. The healthcare provider may provide instructions regarding hydration to help flush the contrast media from the body. Patients are typically advised to report any unusual symptoms, such as pain or difficulty urinating, following the procedure. Additionally, the results of the radiographs will be reviewed, and further management or treatment options will be discussed based on the findings.

Short Descr INJECTION FOR URETER X-RAY
Medium Descr INJ PX URETEROGRAPHY/URETEROPYLOGRAPHY CATH
Long Descr Injection procedure for ureterography or ureteropyelography through ureterostomy or indwelling ureteral catheter
Status Code Active Code
Global Days 000 - Endoscopic or 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 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) I1F - Standard imaging - other
MUE 1
CCS Clinical Classification 200 - Nonoperative urinary system measurements

This is a primary code that can be used with these additional add-on codes.

50606 Addon Code MPFS Status: Active Code APC N ASC N1 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)
50705 Addon Code MPFS Status: Active Code APC N ASC N1 Ureteral embolization or occlusion, including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation (List separately in addition to code for primary procedure)
50706 Addon Code MPFS Status: Active Code APC N ASC N1 Balloon dilation, ureteral stricture, including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation (List separately in addition to code for primary procedure)
74425 Add-on Code MPFS Status: Active Code APC Q2 ASC N1 Physician Quality Reporting PUB 100 CPT Assistant Article Urography, antegrade, radiological supervision and interpretation
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).
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.
XS Separate structure, a service that is distinct because it was performed on a separate organ/structure
RT Right side (used to identify procedures performed on the right side of the body)
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).
52 Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient 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.
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.)
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
GW Service not related to the hospice patient's terminal condition
LT Left side (used to identify procedures performed on the left side of the body)
Q6 Service furnished under a fee-for-time compensation arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area
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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