2025 CPT code 50434
(Deleted) Effective Date: N/A Deletion Date: N/A Surgical Procedures - Urinary System Surgery Feed
Conversion of a nephrostomy catheter to a nephroureteral catheter through the skin, using imaging guidance, including diagnostic nephrostogram and/or ureterogram, and radiological supervision and interpretation.
Modifiers may be applicable depending on the specific circumstances of the procedure, such as increased procedural services (22), bilateral procedure (50), reduced services (52), etc. Consult modifier guidelines for appropriate usage.
Medical necessity should be established by documenting the blockage in the ureter necessitating conversion from a nephrostomy catheter to a nephroureteral catheter.
The physician is responsible for prepping and anesthetizing the patient, using imaging guidance to convert the nephrostomy catheter to a nephroureteral catheter through a pre-existing access route, ensuring correct positioning, attaching the catheter to an external drainage system, bandaging the stoma, and may inject contrast material for visualization and image acquisition. This includes radiological supervision and interpretation.
In simple words: A procedure to change a tube draining urine from the kidney to a tube that drains urine from both the kidney and the ureter, using a small incision in the skin.The procedure uses imaging technology to guide the placement of the new tube, and includes x-ray dye if needed to see the urinary tract clearly. The doctor overseeing the imaging and interpreting the images is included in this procedure.
Percutaneous conversion of nephrostomy catheter to nephroureteral catheter, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation, via pre-existing nephrostomy tract. This procedure involves converting an existing nephrostomy catheter to a nephroureteral catheter through a small incision in the skin. It includes imaging guidance (e.g., ultrasound, fluoroscopy) to ensure proper placement, and may also involve injecting contrast material to visualize the kidney and ureter. Radiological supervision and interpretation are included.
Example 1: A patient with a blocked ureter and an existing nephrostomy catheter requires conversion to a nephroureteral catheter for improved drainage., A patient post-surgery with a nephrostomy catheter needs it converted to a nephroureteral catheter for continued monitoring and drainage of the kidney and ureter., A patient with a complex kidney stone requires a nephroureteral catheter for both drainage and access for future stone removal procedures, after initially having a nephrostomy catheter.
Documentation should include the reason for the conversion, imaging findings confirming the blockage and guiding the procedure, type of catheter used, and any complications encountered. Confirmation of the pre-existing nephrostomy tract should also be documented.
** This code was deleted and replaced by other, more specific codes. Check current CPT coding guidelines for appropriate alternative codes for reporting this procedure.
- Revenue Code: P5E - AMBULATORY PROCEDURES - OTHER
- Specialties:Urology, Interventional Radiology
- Place of Service:Ambulatory Surgical Center, Hospital Outpatient, Inpatient Hospital (if medically necessary)