In simple words: The doctor uses a thin, flexible tube with a camera (endoscope) to look inside the kidney through an existing tube already placed in the kidney. They may clean or flush the kidney and may take x-rays (billed separately).The doctor will remove any foreign object or kidney stone.

This CPT code encompasses renal endoscopy performed through a pre-existing nephrostomy or pyelostomy tract.The procedure involves the insertion of an endoscope into the kidney to examine the renal pelvis, ureter, and kidney itself.Irrigation, instillation of therapeutic solutions, and ureteropyelography (with contrast, billed separately) may be included. The procedure culminates in the removal of a foreign body or calculus.The removal of the nephrostomy or pyelostomy tube and reinsertion of the drainage tube are also integral parts of this procedure.Radiologic services are separately reported.

Example 1: A patient presents with a history of a nephrostomy tube in place for drainage.The patient experiences worsening symptoms, and imaging reveals a kidney stone obstructing the urinary tract.The physician performs a renal endoscopy through the nephrostomy tract, removing the stone., A patient with a pyelostomy tube in place after previous surgery complains of persistent discomfort and hematuria. Endoscopy is performed to explore the renal pelvis and identify the cause. During the procedure, a small blood clot is removed with forceps., A patient with a history of renal calculi presents with recurring flank pain and hematuria.The physician performs a renal endoscopy through an existing nephrostomy tube to remove a small calculus.Irrigation is performed to clear the renal pelvis.

* Preoperative diagnosis and clinical indication for the procedure.* Documentation of the existing nephrostomy or pyelostomy tract.* Detailed description of the endoscopic procedure, including irrigation, instillation, and ureteropyelography (if performed).* Description of the foreign body or calculus removed (size, type, number).* Postoperative findings and patient condition.* Anesthesia records (if applicable).* Pathology report if tissue is sent for examination.

** This procedure is typically performed under fluoroscopic guidance, but the radiological service is billed separately. If ureteropyelography is performed, it should also be billed separately.Always refer to the most current CPT manual and payer guidelines for accurate coding.