How To Use CPT Code 50561

CPT 50561 describes the procedure of renal endoscopy through an established nephrostomy or pyelostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service. This article will cover the description, official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 50561?

CPT 50561 can be used to describe the procedure of renal endoscopy performed through a previously established opening between the collecting system of the kidney and the exterior of the body or a previously established opening between the renal pelvis and the exterior of the body. This code is used when the provider examines the kidney, renal pelvis, and ureter using an endoscope and removes a foreign body or stone.

2. Official Description

The official description of CPT code 50561 is: ‘Renal endoscopy through established nephrostomy or pyelostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with removal of foreign body or calculus.’

3. Procedure

1. The provider disconnects the external urinary drainage bag from the nephrostomy or pyelostomy tube.
2. A guidewire is moved forward through the nephrostomy tube and the nephrostomy tube is pulled out over the wire.
3. The provider widens the opening passageway using surgical instruments if necessary.
4. An endoscope is inserted into the kidney through the established nephrostomy or pyelostomy tract.
5. The provider uses the endoscope to examine the interior structures of the renal collecting system.
6. Sterile saline solution may be added to improve visual perception.
7. Therapeutic solutions may be instilled into the kidney or contrast material may be used for separately reportable radiologic examination of the ureter and renal pelvis.
8. A special instrument like a grasping forceps or a stone retrieval basket is introduced through the endoscope to grasp and remove foreign body or calculus.
9. The provider examines the renal collecting system again to ensure there is no residual foreign body or calculus.
10. All instruments are withdrawn, tubes are replaced, and the external urinary drainage bag is reconnected for temporary urine flow.

4. Qualifying circumstances

Patients eligible for CPT 50561 are those who require renal endoscopy through an established nephrostomy or pyelostomy for the removal of a foreign body or calculus. The procedure is performed by a qualified healthcare provider. The patient must have a previously established opening between the collecting system of the kidney and the exterior of the body or a previously established opening between the renal pelvis and the exterior of the body.

5. When to use CPT code 50561

CPT code 50561 should be used when a provider performs renal endoscopy through an established nephrostomy or pyelostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service, and removes a foreign body or calculus. This code should not be used for procedures involving radiologic services or other interventions.

6. Documentation requirements

To support a claim for CPT 50561, the provider must document the following information:

• Indication for the procedure and the need for renal endoscopy
• Details of the procedure performed, including the use of irrigation, instillation, or ureteropyelography
• Date and duration of the procedure
• Findings during the endoscopy, including the presence of a foreign body or calculus
• Details of any therapeutic solutions or contrast material used
• Confirmation of complete removal of the foreign body or calculus
• Replacement of tubes and reconnection of the external urinary drainage bag
• Signature of the performing provider

7. Billing guidelines

When billing for CPT 50561, ensure that the procedure meets the criteria described in the official description. This code should not be reported with codes for radiologic services or other interventions. Review the documentation requirements and ensure all necessary information is included in the claim. It is important to follow the specific guidelines provided by the payer for accurate and appropriate billing.

8. Historical information

CPT 50561 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 provider performs renal endoscopy through an established nephrostomy to remove a kidney stone.
2. An endoscopist examines the renal pelvis and ureter through a previously established pyelostomy and removes a foreign body.
3. A urologist performs renal endoscopy through an established nephrostomy, uses irrigation, and removes a calculus.
4. A surgeon performs renal endoscopy through an established pyelostomy, performs ureteropyelography, and removes a foreign body.