2025 CPT code 50385
(Active) Effective Date: N/A Surgery - Surgical Procedures on the Urinary System Surgery Feed
Removal (via snare/capture) and replacement of internally dwelling ureteral stent via a transurethral approach, without the use of cystoscopy, including radiological supervision and interpretation.
Modifiers may be applicable depending on the circumstances of the procedure (e.g., bilateral procedure, increased procedural services, assistant surgeon).Refer to current CPT guidelines for correct modifier usage.
Medical necessity must be clearly documented. Examples include blockage of urine flow, recurrent infections, pain, or other complications related to the existing stent or underlying condition.The documentation should support the need for the procedure and why less invasive options are not appropriate.
The physician is responsible for the entire procedure, including prepping and anesthetizing the patient, inserting and manipulating catheters and guidewires, injecting contrast, using fluoroscopy to guide the procedure, removing the old stent, and placing and confirming the position of the new stent.This requires specialized training in urological procedures and the use of fluoroscopic imaging.
In simple words: This procedure replaces a small tube (stent) in the ureter (the tube that carries urine from the kidney to the bladder). The doctor uses a thin wire and x-ray images to guide the new stent into place without needing a scope to look inside the bladder.
This procedure involves the removal and replacement of an indwelling ureteral stent.The physician uses a transurethral approach and imaging guidance (fluoroscopy) but does not use a cystoscope. After prepping and anesthetizing the patient, a catheter is passed into the bladder, and contrast is injected. A guidewire is advanced into the bladder.Under fluoroscopic guidance, a snare or other capturing device is used to grasp the distal end of the existing stent. The stent is then pulled into the bladder and urethra and removed.The guidewire is then placed through the ureter and into the renal pelvis. The new stent is introduced over the guidewire and positioned. The guidewire is removed, and the stent placement is confirmed using fluoroscopy.
Example 1: A patient with a partially blocked ureter and an existing indwelling stent requires a stent exchange due to encrustation or stent malfunction., A patient with a history of recurrent ureteral stones requires a temporary indwelling stent, and the initial stent needs to be replaced., A patient undergoing cancer treatment requires a ureteral stent to maintain urine flow, and the stent needs to be exchanged periodically.
Documentation should include the medical necessity for the stent replacement, details of the procedure including the type of stent used, confirmation of placement using fluoroscopy, any complications encountered, and the patient's tolerance of the procedure. Operative notes, radiological images and reports are essential.
- Specialties:Urology, Interventional Radiology
- Place of Service:Ambulatory Surgical Center, Hospital Outpatient, Inpatient Hospital (if medically necessary)