How To Use CPT Code 50570

CPT 50570 describes the procedure of renal endoscopy through nephrotomy or pyelotomy, 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 50570?

CPT 50570 can be used to describe the procedure of renal endoscopy through nephrotomy or pyelotomy. This involves the insertion of an endoscope after creating an opening between the collecting system of the kidney and the exterior of the body or between the renal pelvis and the exterior of the body. The provider examines the kidney, renal pelvis, and ureter during this procedure.

2. Official Description

The official description of CPT code 50570 is: ‘Renal endoscopy through nephrotomy or pyelotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service.’ It is important to note that for nephrotomy, CPT code 50045 should be used, and for pyelotomy, CPT code 50120 should be used.

3. Procedure

1. The provider prepares the patient and administers anesthesia.
2. An incision is made in the skin over the kidney or renal pelvis.
3. An endoscope, a small, bendable tube with a fastened optical system, is inserted into the kidney through the incision.
4. The provider examines the structures of the renal collecting system using the endoscope.
5. Sterile saline solution may be added to improve visual perception.
6. 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.
7. Once the examination is complete, the endoscope is removed.
8. A drainage tube may be placed for temporary urine flow through a separate incision.
9. The skin incision is closed with sutures.

4. Qualifying circumstances

CPT 50570 is performed on patients who require renal endoscopy through nephrotomy or pyelotomy. This procedure is typically done to examine the structures of the renal collecting system, such as the kidney, renal pelvis, and ureter. It is important to note that for nephrotomy, CPT code 50045 should be used, and for pyelotomy, CPT code 50120 should be used.

5. When to use CPT code 50570

CPT code 50570 should be used when performing renal endoscopy through nephrotomy or pyelotomy. It is important to select the appropriate code based on the specific procedure performed. If the procedure involves nephrotomy, CPT code 50045 should be used. If the procedure involves pyelotomy, CPT code 50120 should be used.

6. Documentation requirements

To support a claim for CPT 50570, the provider must document the following information:

• Patient’s diagnosis and the medical necessity for the procedure
• Details of the procedure performed, including whether irrigation, instillation, or ureteropyelography was performed
• Date of the procedure
• Start and end time of the procedure
• Any additional therapeutic solutions or contrast material used
• Placement of a drainage tube, if applicable
• Closure of the skin incision
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 50570, ensure that the procedure performed is renal endoscopy through nephrotomy or pyelotomy. It is important to use the appropriate code based on the specific procedure performed. If the procedure involves nephrotomy, CPT code 50045 should be used. If the procedure involves pyelotomy, CPT code 50120 should be used. It is also important to follow any additional guidelines provided by the payer or coding guidelines.

8. Historical information

CPT 50570 was added to the Current Procedural Terminology system on January 1, 1990. The code has not undergone any updates or changes since its addition.

9. Examples

1. A provider performs renal endoscopy through nephrotomy to examine the structures of the renal collecting system in a patient with suspected kidney stones.
2. During a procedure, a provider performs renal endoscopy through pyelotomy to examine the renal pelvis and ureter in a patient with recurrent urinary tract infections.
3. A patient with a history of kidney disease undergoes renal endoscopy through nephrotomy to assess the condition of the renal collecting system.
4. A provider performs renal endoscopy through pyelotomy to investigate the cause of persistent hematuria in a patient.
5. During a procedure, a provider performs renal endoscopy through nephrotomy to remove a renal calculus from the renal collecting system.
6. A patient with a suspected ureteral obstruction undergoes renal endoscopy through pyelotomy to evaluate the condition of the ureter.
7. A provider performs renal endoscopy through nephrotomy to assess the renal collecting system in a patient with unexplained flank pain.
8. During a procedure, a provider performs renal endoscopy through pyelotomy to investigate the cause of recurrent urinary tract infections in a patient.
9. A patient with a history of renal pelvis abnormalities undergoes renal endoscopy through nephrotomy to monitor the condition of the renal collecting system.