How To Use CPT Code 50390

CPT 50390 describes the procedure of aspiration and/or injection of a renal cyst or pelvis by a needle, performed percutaneously. This article will provide an overview of CPT code 50390, including its official description, the procedure involved, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and examples.

1. What is CPT Code 50390?

CPT 50390 is used to describe the procedure of aspiration and/or injection of a renal cyst or pelvis using a needle. This procedure is performed percutaneously, meaning that the needle is inserted through the skin and into the cyst or pelvis. The purpose of this procedure is to drain the cyst or inject it with a fluid, such as a sclerosing agent, to alleviate symptoms or evaluate any abnormal passages between the cyst and the calyceal system.

2. Official Description

The official description of CPT code 50390 is: ‘Aspiration and/or injection of renal cyst or pelvis by needle, percutaneous.’

3. Procedure

1. The healthcare provider uses imaging guidance to locate the renal cyst or pelvis.
2. A needle is inserted through the skin and into the cyst or pelvis.
3. If aspiration is performed, the provider removes fluid from the cyst and sends samples to the laboratory for evaluation.
4. If injection is performed, the provider first injects contrast material into the cystic lesion to evaluate any abnormal passages.
5. The provider then injects a sclerosing solution into the cyst to treat it or remove it.

4. Qualifying circumstances

CPT 50390 is performed on patients with renal cysts or pelvis that require aspiration or injection. These cysts may cause symptoms such as abdominal pain, repeated urination, or hematuria. The procedure is performed by a healthcare provider using a needle inserted percutaneously. The provider may also use imaging guidance to ensure accurate placement of the needle.

5. When to use CPT code 50390

CPT code 50390 should be used when a healthcare provider performs the aspiration and/or injection of a renal cyst or pelvis using a needle inserted percutaneously. This code is appropriate when the procedure is performed to drain the cyst or inject it with a fluid, such as a sclerosing agent. It is important to note that CPT code 50390 should not be reported if other codes, such as those for radiological supervision and interpretation or antegrade nephrostogram and/or antegrade pyelogram, are already performed within the same session.

6. Documentation requirements

To support a claim for CPT code 50390, the healthcare provider must document the following information:

• Patient’s diagnosis and the need for aspiration and/or injection of the renal cyst or pelvis
• Details of the procedure, including the use of imaging guidance and the type of fluid injected, if applicable
• Date and time of the procedure
• Any abnormal passages identified during the procedure
• Progress made by the patient and any follow-up plans
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT code 50390, ensure that the procedure is performed percutaneously using a needle. It is important to follow the specific guidelines for reporting this code and to avoid reporting it if other related codes have already been billed within the same session. Additionally, consider any applicable modifiers that may be required for accurate billing.

8. Historical information

CPT code 50390 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates or changes to the code since its addition.

9. Examples

1. A urologist performing percutaneous aspiration of a renal cyst to alleviate abdominal pain in a patient.
2. An interventional radiologist injecting a sclerosing agent into a renal cyst to treat hematuria in a patient.
3. A nephrologist using imaging guidance to perform percutaneous aspiration of a renal pelvis to evaluate abnormal passages in a patient.
4. An oncologist injecting contrast material into a renal cyst to assess its size and location before performing a sclerosing procedure in a patient.
5. A radiologist performing percutaneous aspiration of a renal cyst and sending fluid samples to the laboratory for evaluation in a patient.
6. A urologist injecting a sclerosing solution into a renal cyst to remove it and alleviate symptoms in a patient.
7. An interventional radiologist using imaging guidance to perform percutaneous aspiration of a renal pelvis and injecting a sclerosing agent to treat a complex cyst in a patient.
8. A nephrologist injecting contrast material into a renal cyst to evaluate any abnormal passages before performing a sclerosing procedure in a patient.
9. An oncologist performing percutaneous aspiration of a renal cyst and sending fluid samples for cytology analysis in a patient.
10. A radiologist injecting a sclerosing solution into a renal cyst to treat recurrent infections in a patient.