In simple words: The doctor uses a pre-existing pathway to inject dye into your kidney or ureter to take special x-ray pictures. This helps them see the internal structures and check for any blockages or leaks. The procedure includes the doctor's expertise in reading the images.

This code describes a diagnostic imaging procedure of the kidney (nephrostogram) and/or ureter (ureterogram). It is performed by injecting contrast material through an existing access route into the urinary system under image guidance (ultrasound and/or fluoroscopy). This code includes all associated radiological supervision and interpretation.

Example 1: A patient with a nephrostomy tube in place experiences flank pain. A nephrostogram through the existing nephrostomy tube access is performed using code 50431 to assess for tube blockage or leakage., A patient with a history of ureteral stricture presents with recurrent urinary tract infections. A ureterogram via a pre-existing ureteral access sheath is performed using code 50431 to evaluate the ureter for blockage or narrowing., A post-surgical patient with a nephroureteral stent experiences decreased urine output. A nephrostogram and ureterogram through the existing stent access is done using 50431 to check for stent malfunction or obstruction.

Documentation should include details of the existing access, the imaging guidance used, contrast agent administered, findings of the nephrostogram/ureterogram, and the physician’s interpretation. Medical necessity for the procedure should also be documented.

** It is important to distinguish between new access (50430) and existing access (50431) when coding for a nephrostogram/ureterogram. The existing access is typically a nephrostomy tube, ureteral stent, or other previously established pathway.For bilateral procedures, where two separate accesses exist, code 50431 can be reported twice with modifier 50.iFrameAI may be beneficial in keeping up with all the newest requirements for accurate documentation and coding.