How To Use CPT Code 50430

CPT 50430 describes the injection procedure for antegrade nephrostogram and/or ureterogram, which is a complete diagnostic procedure including imaging guidance and all associated radiological supervision and interpretation. 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 50430?

CPT 50430 can be used to describe the injection procedure for antegrade nephrostogram and/or ureterogram. This procedure involves creating a new access route percutaneously and injecting contrast material into the ureters or kidney to analyze the internal structures using imaging guidance. The provider typically performs this procedure to assess nephrostomy or pyelostomy tube function, identify blockage in the ureteropelvic junction, or check for urine leakage around the tube insertion site.

2. Official Description

The official description of CPT code 50430 is: ‘Injection procedure for antegrade nephrostogram and/or ureterogram, complete diagnostic procedure including imaging guidance (eg, ultrasound and fluoroscopy) and all associated radiological supervision and interpretation; new access.’

3. Procedure

1. The provider prepares the patient and uses ultrasound or fluoroscopic guidance to make a small incision in the patient’s skin over the kidneys.
2. A needle is inserted through the incision, and a guide wire is placed into the ureters and/or renal pelvis.
3. A catheter is advanced over the guide wire, and the contrast material is injected into the areas to be imaged.
4. The provider takes images of the kidney, renal pelvis, and/or ureter and interprets the images to analyze the internal structures.

4. Qualifying circumstances

Patients who may require CPT 50430 are those who need an antegrade nephrostogram and/or ureterogram to assess the function of nephrostomy or pyelostomy tubes, identify blockages, or check for urine leakage. The procedure is performed using imaging guidance, such as ultrasound and fluoroscopy, and includes all associated radiological supervision and interpretation.

5. When to use CPT code 50430

CPT code 50430 should be used when the provider performs a complete diagnostic procedure for antegrade nephrostogram and/or ureterogram, including imaging guidance and all associated radiological supervision and interpretation. This code should be used for each instance of the procedure performed.

6. Documentation requirements

To support a claim for CPT 50430, the provider must document the following information:

• Patient’s condition and the need for the procedure
• Details of the procedure performed, including the use of imaging guidance
• Date and duration of the procedure
• Specific areas imaged and any findings or interpretations
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 50430, ensure that the procedure meets the criteria for a complete diagnostic procedure for antegrade nephrostogram and/or ureterogram. The code includes all associated radiological supervision and interpretation, so separate coding for these services is typically not necessary. Review CPT and payer-specific guidelines for any additional requirements or considerations.

8. Historical information

CPT 50430 was added to the Current Procedural Terminology system on January 1, 2016. There have been no updates to the code since its addition.

9. Examples

1. A provider performs a complete diagnostic procedure for antegrade nephrostogram to assess the function of a nephrostomy tube in a patient with kidney stones.
2. A provider performs a complete diagnostic procedure for antegrade ureterogram to identify a blockage in the ureteropelvic junction in a patient with recurrent urinary tract infections.
3. A provider performs a complete diagnostic procedure for antegrade nephrostogram to check for urine leakage around the site of a pyelostomy tube insertion in a patient with a history of kidney surgery.
4. A provider performs a complete diagnostic procedure for antegrade ureterogram to assess the function of a nephrostomy tube in a patient with hydronephrosis.
5. A provider performs a complete diagnostic procedure for antegrade nephrostogram to evaluate the internal structures of the kidney in a patient with suspected renal abnormalities.
6. A provider performs a complete diagnostic procedure for antegrade ureterogram to identify a blockage in the ureter in a patient with flank pain.
7. A provider performs a complete diagnostic procedure for antegrade nephrostogram to assess the function of a nephrostomy tube in a patient with a history of kidney stones.
8. A provider performs a complete diagnostic procedure for antegrade ureterogram to check for urine leakage around the site of a pyelostomy tube insertion in a patient with a history of bladder cancer.
9. A provider performs a complete diagnostic procedure for antegrade nephrostogram to evaluate the internal structures of the kidney in a patient with suspected renal cysts.
10. A provider performs a complete diagnostic procedure for antegrade ureterogram to identify a blockage in the ureteropelvic junction in a patient with recurrent kidney infections.