2025 CPT code 50606
Effective Date: N/A Surgical Procedures on the Urinary System - Urinary System Surgery Feed
Endoluminal biopsy of ureter and/or renal pelvis, non-endoscopic, including imaging guidance (e.g., ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation. (List separately in addition to code for primary procedure)
Modifier 50 (Bilateral Procedure) should be used if the procedure is performed on both ureters.Do not append modifier 50 to add-on codes when a procedure is performed bilaterally; instead, you should report the add-on code twice. other modifiers applicable as per procedure
Medical necessity for this procedure must be established through documentation supporting the need for the biopsy, such as suspicious imaging findings or clinical symptoms. The documentation should clearly indicate why the biopsy is necessary for diagnosis or treatment planning.
The physician accesses the ureter or renal pelvis using a non-endoscopic approach, such as through an existing nephrostomy catheter.Imaging guidance is utilized to visualize the target area and direct the biopsy instrument. The physician obtains a tissue sample using a brush or similar device, then withdraws the instrument and completes the procedure.
In simple words: A small tissue sample is taken from the inside of the tube that carries urine from the kidney to the bladder (ureter) or the part of the kidney that collects urine (renal pelvis). This is done using a special brush and imaging technology like ultrasound or x-ray to guide the procedure. It's not done with a camera scope.This procedure is usually done along with another procedure.
This code describes an endoluminal biopsy (e.g., brush) of the ureter and/or renal pelvis performed using non-endoscopic imaging guidance such as ultrasound and/or fluoroscopy. The procedure includes all associated radiological supervision and interpretation.The biopsy may be performed through de novo transrenal access, an existing renal/ureteral access, transurethral access, an ileal conduit, or ureterostomy. The service of gaining access may be reported separately. Diagnostic pyelography/ureterography is not included and may be reported separately.Other interventions or catheter placements performed at the same setting as the biopsy may be reported separately.This code is an add-on code and should be reported in addition to the primary procedure code.
Example 1: A patient with a nephrostomy tube in place requires a biopsy of the renal pelvis to evaluate a suspicious lesion identified on imaging. Code 50606 is reported in addition to the appropriate nephrostomy tube code., A patient with a ureteral stent requires a biopsy of a suspected tumor in the ureter. The biopsy is performed through the stent using imaging guidance. Code 50606 is reported in addition to the ureteral stent placement code., During a percutaneous nephrostomy tube placement (e.g., 50430), a biopsy of the renal pelvis is also performed. Code 50606 would be reported as an add-on code to 50430.
Documentation should include details of the primary procedure, the reason for the biopsy, the approach used, the imaging guidance method, the location of the biopsy, and the findings.A pathology report should also be included in the documentation.
** Code 50606 includes imaging guidance, radiological supervision, and interpretation.
- Revenue Code: P1G - Major Procedure - Other
- Specialties:Urology, Interventional Radiology
- Place of Service:Inpatient Hospital, Outpatient Hospital, Ambulatory Surgical Center