CPT® Code 50686

Official Description

Manometric studies through ureterostomy or indwelling ureteral catheter

Common Language Description

Manometric studies are specialized diagnostic procedures that assess the function of the ureters, which are the tubes that carry urine from the kidneys to the bladder. These studies are 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 that has been previously placed. The primary purpose of these studies is to evaluate ureteral function and diagnose conditions such as ureteral reflux. Ureteral reflux is a condition characterized by the abnormal backflow of urine from the bladder into the kidneys, which can lead to serious complications if not addressed. This backflow occurs when the normal valve-like mechanism at the junction of the ureter and bladder fails, which can be due to various anatomical or functional issues. During manometric studies, a specialized catheter equipped with a manometer sensor is inserted into the ureter, either through the stoma or the existing catheter. This sensor measures the pressure within the ureter, providing valuable data on the strength and function of the ureteral muscles. The pressure readings are transmitted to a computer for analysis, allowing healthcare professionals to gain insights into the ureter's performance and identify any underlying issues that may require further intervention.

1. Indications

Manometric studies through ureterostomy or indwelling ureteral catheter are indicated for the evaluation of specific conditions related to ureteral function. These indications include:

Ureteral Reflux - This condition occurs when urine flows backward from the bladder into the kidneys, potentially leading to kidney damage or infection.
Assessment of Ureteral Function - These studies help determine how well the ureters are functioning, particularly in patients with known or suspected ureteral abnormalities.
Investigation of Urinary Tract Symptoms - Patients presenting with unexplained urinary symptoms may undergo these studies to identify underlying ureteral issues.

2. Procedure

The procedure for conducting manometric studies through a ureterostomy or indwelling ureteral catheter involves several key steps:

Step 1: Preparation - The patient is positioned comfortably, and the area around the ureterostomy or catheter insertion site is cleaned and sterilized to prevent infection.
Step 2: Catheter Insertion - A specialized catheter equipped with a manometer sensor is carefully inserted into the ureter through the stoma or the existing indwelling ureteral catheter. This step requires precision to ensure accurate placement within the ureter.
Step 3: Pressure Measurement - Once the catheter is in place, the manometer sensor begins to measure the pressure within the ureter. This data is crucial for assessing the muscular function of the ureter.
Step 4: Data Transmission - The pressure readings collected by the sensor are transmitted to a computer system for analysis. This allows for real-time monitoring of ureteral function during the study.
Step 5: Data Analysis - After the procedure, the recorded pressure data is analyzed to evaluate the strength and function of the ureteral muscles, helping to identify any abnormalities or dysfunction.

3. Post-Procedure

After the completion of manometric studies, patients may require specific post-procedure care. This includes monitoring for any signs of complications, such as infection or discomfort at the catheter insertion site. Patients are typically advised to maintain hydration and may be instructed on how to care for the ureterostomy or catheter. Follow-up appointments may be scheduled to discuss the results of the manometric studies and to determine any necessary further interventions based on the findings.

Short Descr	MEASURE URETER PRESSURE
Medium Descr	MANOMETRIC STDS THRU URTROST/NDWELLG URTRL CATH
Long Descr	Manometric studies 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)	0 - 150% payment adjustment for bilateral procedures does NOT apply.
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.
Diagnostic Imaging Family	99 - Concept Does Not Apply
APC Status Indicator	Procedure or Service, Not Discounted when Multiple
ASC Payment Indicator	Office-based surgical procedure added to ASC list in CY 2008 or later with MPFS nonfacility PE RVUs; payment based on MPFS nonfacility PE RVUs.
Type of Service (TOS)	2 - Surgery
Berenson-Eggers TOS (BETOS)	P6C - Minor procedures - other (Medicare fee schedule)
MUE	2
CCS Clinical Classification	200 - Nonoperative urinary system measurements