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2025 CPT code 50430

Injection procedure for antegrade nephrostogram and/or ureterogram; complete diagnostic procedure including imaging guidance and all associated radiological supervision and interpretation; new access.

Follow all applicable CPT coding guidelines for percutaneous genitourinary procedures and radiological services. The renal pelvis and its associated ureter are considered a single entity for reporting purposes.Appropriate modifiers may be necessary depending on the specific circumstances of the case.

Modifiers 50 (bilateral procedure) and 59 (distinct procedural service) may apply.Other modifiers may be appropriate depending on specific circumstances; consult the AMA CPT manual and payer-specific guidelines.

Medical necessity for this procedure is established when there is a clinical indication for evaluation of the renal collecting system and/or ureters. This may include suspected obstruction, assessment of nephrostomy tube function, or pre-operative planning for complex urological interventions.The procedure should be medically appropriate and not performed for unnecessary purposes.

The physician is responsible for all aspects of the procedure, including patient preparation and anesthesia, image guidance (ultrasound or fluoroscopy), creating the access route, injecting contrast material, obtaining and interpreting images, and post-procedure care.

IMPORTANT:Should not be reported with 50432, 50433, 50434, 50435, 50693, 50694, 50695.Codes 50430 and 50431 are diagnostic procedure codes that include injection(s) of contrast material, all associated radiological supervision and interpretation, and procedural imaging guidance.

In simple words: This procedure involves a small incision in the skin to create a new access route into the kidney or ureter.A special dye is injected to create an X-ray image (nephrostogram or ureterogram) of the kidneys and ureters. The doctor uses ultrasound or fluoroscopy (live x-ray) to guide the procedure and interpret the resulting images.

This CPT code 50430 represents a percutaneous injection procedure for an antegrade nephrostogram and/or ureterogram.The procedure involves creating new access to the renal collecting system, injecting contrast material, and obtaining images.It includes all associated radiological supervision, interpretation, and imaging guidance (e.g., ultrasound and fluoroscopy). The renal pelvis and its associated ureter are considered a single entity for reporting purposes.The code may be reported once for each renal collecting system/ureter accessed.It should not be reported with 50432, 50433, 50434, 50435, 50693, 50694, 50695.

Example 1: A patient presents with suspected ureteral obstruction. The physician performs a percutaneous antegrade nephrostogram to visualize the urinary tract and confirm the blockage location., A patient with a nephrostomy tube in place needs assessment for possible malfunction.The physician performs an antegrade nephrostogram and ureterogram to evaluate tube placement and assess for leaks or obstructions., A patient requires assessment of the renal collecting system prior to a complex endourological intervention. The physician utilizes this procedure to guide placement of additional instruments.

Detailed clinical history indicating the need for the procedure, informed consent, images obtained during the procedure, radiology reports interpreting the findings, and post-procedure notes documenting the patient’s condition and any complications.

** This code should be used when a new access route into the renal collecting system is created during the nephrostogram/ureterogram.If a pre-existing tract is used, a different code may be appropriate.Always refer to the latest CPT guidelines for the most up-to-date coding information.

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