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Ureteral endoscopy is a minimally invasive procedure that involves the examination and treatment of the ureter through an established ureterostomy, which is an opening created surgically to allow urine to exit the body. This procedure utilizes a ureteroscope, a specialized instrument designed to visualize the interior of the ureter. The ureteroscope is introduced through the ureterostomy, allowing the physician to inspect the ureter for any abnormalities such as obstructions, stenosis (narrowing), or strictures (abnormal tightening). During the procedure, the ureter may be irrigated with normal saline to clear any debris or obstructions, and diagnostic or therapeutic solutions can be instilled to aid in treatment. Additionally, contrast material may be injected to perform ureteropyelography, a radiologic examination of the ureters and kidneys, although this imaging service is not included in the CPT® code itself. Following the visual examination, a ureteral catheter is advanced through the ureteroscope to facilitate further treatment. If any stenosis is detected, a balloon-tipped catheter can be introduced to the site of the narrowing and inflated to dilate the ureter. This dilation process may involve multiple inflations and deflations of the balloon until the stenotic area is adequately treated. After the necessary interventions are completed, all instruments are carefully removed, concluding the procedure.
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The procedure is indicated for various conditions affecting the ureter, including:
The procedure involves several key steps, which are detailed as follows:
Post-procedure care may include monitoring for any complications such as bleeding or infection at the ureterostomy site. Patients may be advised to maintain hydration and report any unusual symptoms, such as increased pain or changes in urine output. Follow-up appointments may be necessary to assess the success of the procedure and to determine if further interventions are required.
| Short Descr | ENDOSCOPY OF URETER | Medium Descr | URETERAL ENDOSCOPY VIA URETEROST W/WO DIL URETER | Long Descr | Ureteral endoscopy through established ureterostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with ureteral catheterization, with or without dilation of ureter | 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 | 50951 Ureteral endoscopy through established ureterostomy, 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 | Surgical procedure on ASC list in CY 2007; 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 | 102 - Ureteral catheterization |
| 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). | 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.) | 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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