How To Use CPT Code 50385

CPT 50385 describes the procedure for the removal and replacement of an internally dwelling ureteral stent using a transurethral approach, without the use of cystoscopy. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 50385?

CPT 50385 can be used to describe the removal and replacement of an internally dwelling ureteral stent using a transurethral approach, without the use of cystoscopy. This code is used when the provider performs the procedure to remove and replace the stent, ensuring proper drainage and prevention of obstruction in the ureter.

2. Official Description

The official description of CPT code 50385 is: ‘Removal (via snare/capture) and replacement of internally dwelling ureteral stent via transurethral approach, without use of cystoscopy, including radiological supervision and interpretation.’

3. Procedure

1. The provider preps and anesthetizes the patient.
2. A catheter is passed into the bladder, and contrast is injected to visualize the area.
3. A guide wire is advanced into the bladder under fluoroscopic guidance.
4. A snare or capture device is introduced into the bladder to hold the distal portion of the stent tube.
5. The provider pulls the internally dwelling stent tube into the bladder and urethra.
6. Fluoroscopic guidance is used to place the guide wire through the opening of the ureteral stent and into the renal pelvis.
7. The provider removes the stent completely via the urethra and positions the catheter over the guide wire.
8. More contrast is injected to visualize the insertion of the new stent.
9. The provider removes the catheter and introduces a new stent tube over the guide wire.
10. The new stent is positioned within the renal pelvis and in the bladder.
11. The guide wire is removed, and the provider confirms the stent’s position using fluoroscopy.
12. All instruments are removed, and final images are obtained.

4. Qualifying circumstances

Patients eligible to receive CPT 50385 services are those who require the removal and replacement of an internally dwelling ureteral stent. The procedure is performed using a transurethral approach without the use of cystoscopy. The provider must ensure proper drainage and prevention of obstruction in the ureter. The procedure may be necessary for patients with conditions such as urinary tract obstruction or kidney stones.

5. When to use CPT code 50385

CPT code 50385 should be used when the provider performs the removal and replacement of an internally dwelling ureteral stent using a transurethral approach, without the use of cystoscopy. This code should not be used if cystoscopy is performed during the procedure. It is important to accurately document the procedure and ensure that the code is used only when the specific criteria are met.

6. Documentation requirements

To support a claim for CPT 50385, the provider must document the following information:

• Patient’s diagnosis and the need for the removal and replacement of the ureteral stent
• Details of the procedure, including the transurethral approach and absence of cystoscopy
• Date and duration of the procedure
• Use of radiological supervision and interpretation
• Confirmation of the stent’s position using fluoroscopy
• Final images obtained
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 50385, ensure that the procedure is performed using a transurethral approach without the use of cystoscopy. Use the appropriate codes for radiological supervision and interpretation. It is important to accurately document the procedure and meet the specific criteria for reporting CPT 50385. Review the billing guidelines and requirements of the payer to ensure proper reimbursement.

8. Historical information

CPT 50385 was added to the Current Procedural Terminology system on January 1, 2008. There have been no updates to the code since its addition.

9. Examples

1. A urologist performing the removal and replacement of an internally dwelling ureteral stent using a transurethral approach, without the use of cystoscopy, for a patient with urinary tract obstruction.
2. A nephrologist performing the removal and replacement of an internally dwelling ureteral stent using a transurethral approach, without the use of cystoscopy, for a patient with kidney stones.
3. An interventional radiologist performing the removal and replacement of an internally dwelling ureteral stent using a transurethral approach, without the use of cystoscopy, for a patient with a history of ureteral strictures.