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2025 CPT code 50575

Renal endoscopy with endopyelotomy; includes cystoscopy, ureteroscopy, dilation, incision, and stent placement.

Follow all current CPT coding guidelines.Proper documentation is essential for accurate coding and reimbursement.

Modifiers may be applicable depending on the circumstances of the procedure (e.g., bilateral procedure, multiple procedures). Consult the current CPT manual for appropriate modifier use.

Medical necessity is established by the presence of symptoms consistent with UPJ obstruction, confirmed by imaging.The procedure is medically necessary to relieve the obstruction, improve renal function, and prevent complications such as hydronephrosis or infection.

The urologist's responsibilities include performing the renal endoscopy, cystoscopy, ureteroscopy, dilation, incision at the ureteropelvic junction, and stent placement. They also assess the patient's condition, administer anesthesia, and provide post-operative care.

IMPORTANT:If cystoscopy and retrograde pyelogram are performed beforehand, CPT code 52005 may also be billed. If the retrograde pyelogram is documented, CPT code 74420 with modifier 26 can be billed for the professional component.Code 99070 is used for supplies and materials.

In simple words: The doctor uses a thin, flexible tube with a camera (endoscope) to look inside the kidney. They make a small cut to widen a narrowed part of the kidney's drainage system and place a small tube (stent) to help drainage. This may involve looking inside the bladder and ureter as well.

This CPT code encompasses renal endoscopy (through nephrotomy or pyelotomy) with or without irrigation, instillation, or ureteropyelography (excluding radiologic services).The procedure includes cystoscopy, ureteroscopy, dilation of the ureter and ureteropelvic junction, incision of the ureteropelvic junction, and insertion of an endopyelotomy stent.Antegrade or retrograde approaches may be used.The procedure involves visualizing the renal collecting system using an endoscope, widening a narrowed portion of the renal pelvis, and making an incision at the blockage to relieve the obstruction. A stent is then placed for temporary drainage.

Example 1: A 55-year-old male patient presents with symptoms of hydronephrosis due to ureteropelvic junction (UPJ) obstruction.The urologist performs an antegrade endopyelotomy to relieve the obstruction., A 40-year-old female patient has a history of recurrent kidney stones, resulting in UPJ stenosis.A retrograde endopyelotomy with stent placement is performed., A 60-year-old male patient with a history of pelvic trauma presents with UPJ obstruction.The surgeon performs a combined antegrade and retrograde approach for endopyelotomy with stent placement to address the complex anatomy.

* Detailed operative report describing the approach (antegrade or retrograde), instrumentation, and findings.* Pre-operative imaging (e.g., ultrasound, CT scan) demonstrating the UPJ obstruction.* Post-operative imaging (e.g., x-ray) to confirm stent placement.* Patient's medical history, including symptoms and relevant comorbidities.* Anesthesia records.

** Accurate coding requires comprehensive documentation of the entire procedure, including the approach, techniques used, and any complications.Always refer to the most current CPT and payer guidelines for accurate coding and reimbursement.

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