How To Use CPT Code 50574

CPT 50574 describes a specific endoscopic procedure performed on the kidney. This article will cover the description, official details, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 50574?

CPT 50574 is a code used to describe a renal endoscopy procedure. During this procedure, a healthcare provider inserts an endoscope through an incision in the skin over the kidney or renal pelvis to examine the kidney and ureter. The provider may also take a tissue sample for biopsy. This code specifically excludes any radiologic services and may involve irrigation, instillation, or ureteropyelography.

2. Official Description

The official description of CPT code 50574 is: ‘Renal endoscopy through nephrotomy or pyelotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with biopsy.’

3. Procedure

1. After appropriate preparation and anesthesia, the healthcare provider makes an incision in the skin over the kidney or renal pelvis.
2. An endoscope is inserted through the incision to visualize the structures of the renal collecting system.
3. Irrigation with sterile saline solution may be used to improve visualization.
4. The provider may also instill saline solution drop by drop into the kidney.
5. If necessary, contrast material may be administered for radiological examination of the ureter and renal pelvis.
6. The provider then uses a scissor-like surgical device through the endoscope to obtain a small tissue sample for biopsy.
7. After completing the examination and biopsy, the instruments are withdrawn.
8. An external urinary drainage catheter tube may be placed for temporary urine flow.
9. The incision in the kidney or renal pelvis is closed, and the skin incision is sutured.

4. Qualifying circumstances

CPT 50574 is performed on patients who require a renal endoscopy procedure. This may be necessary for diagnostic purposes or to obtain a tissue sample for biopsy. The procedure is typically performed by a healthcare provider with expertise in endoscopy and may involve irrigation, instillation, or ureteropyelography. It is important to note that this code specifically excludes any radiologic services.

5. When to use CPT code 50574

CPT code 50574 should be used when a renal endoscopy procedure is performed through nephrotomy or pyelotomy. This code is appropriate when the procedure includes a biopsy and may involve irrigation, instillation, or ureteropyelography. It is important to ensure that the documentation supports the use of this specific code and excludes any radiologic services.

6. Documentation requirements

To support a claim for CPT 50574, the healthcare provider must document the following information:

• Reason for the procedure and the need for a renal endoscopy
• Details of the specific procedure performed, including any irrigation, instillation, or ureteropyelography
• Date and duration of the procedure
• Specific findings during the examination
• Details of the biopsy, including the site and size of the tissue sample obtained
• Administration of contrast material, if applicable
• Placement of an external urinary drainage catheter tube, if performed
• Closure of the incisions and any additional procedures performed
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT 50574, it is important to ensure that the procedure meets the specific criteria outlined in the code description. This includes performing the procedure through nephrotomy or pyelotomy, with or without irrigation, instillation, or ureteropyelography. It is crucial to exclude any radiologic services. Additionally, consider any applicable modifiers or other coding guidelines provided by payers to accurately report and receive reimbursement for this procedure.

8. Historical information

CPT 50574 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 healthcare provider performs a renal endoscopy through nephrotomy to examine the structures of the renal collecting system and obtain a tissue sample for biopsy.
2. During a renal endoscopy procedure through pyelotomy, a provider uses irrigation to improve visualization and takes a tissue sample for biopsy.
3. A patient undergoes a renal endoscopy with instillation of saline solution drop by drop into the kidney for better visualization and a subsequent biopsy.
4. A healthcare provider performs a renal endoscopy through nephrotomy, administers contrast material for radiological examination, and obtains a tissue sample for biopsy.
5. During a renal endoscopy procedure through pyelotomy, a provider performs ureteropyelography and takes a tissue sample for biopsy.
6. A patient undergoes a renal endoscopy with irrigation using sterile saline solution, followed by a biopsy performed through nephrotomy.
7. A healthcare provider performs a renal endoscopy through pyelotomy, instills saline solution for better visualization, and obtains a tissue sample for biopsy.