How To Use CPT Code 50562

CPT 50562 describes the procedure for 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 50562?

CPT 50562 is used to describe a specific procedure known as renal endoscopy. This procedure involves the insertion of an endoscope through a previously established opening between the kidney and the exterior of the body or between the renal pelvis and the exterior of the body. The purpose of this procedure is to examine the kidney, renal pelvis, and ureter, and to remove a tumor if necessary.

2. Official Description

The official description of CPT code 50562 is: ‘Renal endoscopy through established nephrostomy or pyelostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with resection of tumor.’

3. Procedure

1. The provider begins by disconnecting the external urinary drainage bag from the nephrostomy or pyelostomy tube.
2. A guidewire is then inserted through the nephrostomy tube, and the tube is pulled out over the wire.
3. The provider may use surgical instruments to widen the opening passageway.
4. Once the pathway is widened, 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, and therapeutic solutions or contrast material may be instilled for separate radiologic examination of the ureter and renal pelvis.
7. If a tumor is present, a special endoscopic instrument is used to excise the tumor, taking care not to damage the renal pelvis.
8. The provider examines the renal collecting system to ensure there is no residual tumor.
9. Once the tumor resection is complete, all instruments are withdrawn, and the tubes are replaced.
10. The external urinary drainage bag is then reconnected to the tubes for temporary urine flow.

4. Qualifying circumstances

CPT 50562 is performed on patients who have a previously established nephrostomy or pyelostomy and require renal endoscopy. This procedure is typically performed to examine the renal collecting system and remove tumors. It is important to note that CPT codes 50570-50580 may be added to 50045 and 50120 if they provide a significant identifiable service.

5. When to use CPT code 50562

CPT code 50562 should be used when performing renal endoscopy through an established nephrostomy or pyelostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service, and when a tumor resection is also performed. It is important to accurately document the specific details of the procedure to support the use of this code.

6. Documentation requirements

To support a claim for CPT 50562, the provider must document the following information:

• Confirmation of a previously established nephrostomy or pyelostomy
• Details of the procedure, including any irrigation, instillation, or ureteropyelography performed
• Documentation of the tumor resection
• Any additional significant identifiable services provided

7. Billing guidelines

When billing for CPT 50562, it is important to ensure that the procedure meets the specific criteria outlined in the code description. The use of other codes, such as 50570-50580, should be considered if they provide a significant identifiable service. It is also important to review the specific guidelines provided by payers to ensure accurate billing and reimbursement.

8. Historical information

CPT code 50562 was added to the Current Procedural Terminology system on January 1, 2003. There have been no updates or changes to the code since its addition.

9. Examples

1. A patient with a previously established nephrostomy undergoes renal endoscopy for the removal of a tumor.
2. Renal endoscopy is performed through an established pyelostomy to examine the renal collecting system and remove a tumor.
3. A patient with a nephrostomy tube undergoes renal endoscopy with irrigation and ureteropyelography for the removal of a tumor.
4. Renal endoscopy is performed through an established nephrostomy for the examination of the renal pelvis and ureter, with subsequent tumor resection.
5. A patient with a pyelostomy tube undergoes renal endoscopy with instillation of contrast material for radiologic examination of the renal pelvis and ureter, followed by tumor resection.