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BETA v.3.0

2025 CPT code 50389

Removal of a nephrostomy tube using fluoroscopic guidance, typically due to the presence of an indwelling ureteral stent.

Removal of a nephrostomy tube not requiring fluoroscopic guidance is considered inherent to E/M services. If the nephrostomy tube removal is performed in conjunction with another service, documentation should support a significant increase in effort to append modifier 22.

Modifiers such as 22 (Increased Procedural Services), 50 (Bilateral Procedure), 59 (Distinct Procedural Service), 78 (Return to the Operating Room), etc., may be applicable depending on the specific circumstances of the procedure.

Medical necessity for this procedure must be documented and may include blockage, infection, or the completion of a surgical procedure requiring temporary nephrostomy drainage.

The physician preps and anesthetizes the patient, confirms stent placement and function via contrast injection, removes the nephrostomy tube using fluoroscopic guidance and a guidewire, and dresses the incision site.

In simple words: The doctor removes a tube from your kidney using an x-ray camera to see, especially if you have another small tube helping your urine flow.

This code describes a procedure where the physician removes a nephrostomy tube from the kidney, using fluoroscopy to guide the removal, often because there's a ureteral stent present.

Example 1: A patient with an indwelling ureteral stent requires removal of their nephrostomy tube. Fluoroscopic guidance is used to avoid interaction with the stent during the removal., A patient experiences complications with their nephrostomy tube, such as blockage or infection, and requires removal under fluoroscopic guidance., A patient has a nephrostomy tube placed temporarily during a surgical procedure and needs it removed under fluoroscopic guidance after the procedure is complete due to anatomical challenges.

Documentation should include details of the nephrostomy tube placement, the reason for removal, the use of fluoroscopy, the presence of any indwelling stents or other devices, and any complications encountered during the procedure.

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