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2025 CPT code 50693

Percutaneous placement of a ureteral stent using a pre-existing nephrostomy tract; includes imaging guidance and radiological supervision.

Consult the official CPT manual and payer-specific guidelines for detailed coding instructions and any regional or local variations.Imaging guidance and radiological supervision are included in the code and should not be reported separately.

Modifiers may apply depending on the circumstances of the procedure (e.g., 50 for bilateral procedures, 59 for distinct procedural service, 22 for increased procedural services, etc.). Refer to the CPT manual for specific modifier guidelines.

Medical necessity for percutaneous ureteral stent placement is established by the presence of urinary obstruction or the need to maintain ureteral patency.This could be secondary to various etiologies, such as strictures, calculi, tumors, or post-operative management of urological procedures.Documentation should clearly establish the clinical indication and the benefit of the procedure for the patient.

The urologist or nephrologist is primarily responsible for the percutaneous placement of the ureteral stent.This includes pre-operative evaluation, procedure performance, post-operative care and follow-up. Radiologists may be involved for imaging guidance and interpretation.

IMPORTANT:Codes 50694 and 50695 are related codes for percutaneous ureteral stent placement, differing based on the presence or absence of a new nephrostomy tract and/or new percutaneous access.If a nephrostomy catheter is placed separately during the same session via a new percutaneous access, code 50695 should be used.Code 50434 should be billed if the existing nephrostomy is converted to a nephroureteral catheter.If a double-J stent is placed but the nephrostomy remains, code 50693 is appropriate. If both stent and nephrostomy are placed, both 50693 and 50435 should be used (with 50693 preceding in billing).

In simple words: This code covers placing a thin tube (stent) inside the ureter (tube connecting kidney to bladder) through an already-existing opening in the kidney.Doctors use ultrasound or X-ray imaging to guide the placement. The procedure includes X-ray images of the kidney and ureter.

This CPT code (50693) describes the percutaneous placement of a ureteral stent utilizing a pre-existing nephrostomy tract.The procedure encompasses access via the nephrostomy tract, stent placement,catheter manipulations, and a diagnostic nephrostogram and/or ureterogram if performed.Imaging guidance (ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation are included.A new percutaneous access is not created for this procedure.

Example 1: A patient presents with a ureteral stricture causing hydronephrosis.A nephrostomy tube is already in place.A percutaneous ureteral stent is placed via the existing nephrostomy tract to relieve the obstruction. Code 50693 is reported., A patient with a history of kidney stones and a pre-existing nephrostomy tube experiences recurrent urinary obstruction.A percutaneous ureteral stent is placed using fluoroscopic guidance via the nephrostomy. A nephrostogram is performed. Code 50693 is reported., A patient with ureteral cancer undergoes nephroureterectomy, and a temporary stent is placed percutaneously via pre-existing nephrostomy tract post-operatively to ensure ureteral patency. Code 50693 is reported.

Complete operative report detailing the approach, technique, imaging used, and any complications.Preoperative and postoperative imaging (if performed) and pathology reports (if applicable) should also be documented.Consent form and appropriate medical record entries to support medical necessity are required.

** The use of this code requires a pre-existing nephrostomy tract.If new access is needed, codes 50694 or 50695 should be considered instead.

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