How To Use CPT Code 50580

CPT 50580 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 50580?

CPT 50580 is a code used to describe a specific procedure known as renal endoscopy. During this procedure, a healthcare provider inserts an endoscope through an incision in the skin over the kidney or the renal pelvis to analyze the kidney and ureter. The provider may perform this procedure with or without irrigation, instillation, or ureteropyelography, which involves injecting contrast material to examine the ureter and renal pelvis. Additionally, the provider may remove a foreign body or calculus (stone) during the procedure.

2. Official Description

The official description of CPT code 50580 is: ‘Renal endoscopy through nephrotomy or pyelotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with removal of foreign body or calculus.’

3. Procedure

1. First, the patient is appropriately prepped and anesthetized.
2. The healthcare provider makes an incision in the skin over the kidney or renal pelvis.
3. An endoscope is inserted into the kidney through the incision to analyze the structures of the renal collecting system.
4. To improve visualization, the provider may use sterile saline solution to irrigate the area or instill saline solution drop by drop into the kidney.
5. The provider may also administer contrast material for radiological examination of the ureter and renal pelvis.
6. Once the examination is complete, the provider uses a special instrument, such as grasping forceps or a stone retrieval basket, to grasp and remove a foreign body or calculus.
7. The provider carefully reexamines the renal collecting system to ensure there are no residual foreign bodies or calculi.
8. If necessary, the provider may place a stent into the bladder by passing it through the ureter.
9. All instruments are then withdrawn, and an external urinary drainage catheter tube may be placed for temporary urine flow.
10. Finally, the provider closes the incision in the kidney or renal pelvis and sutures the layers of tissue together to close the skin incision.

4. Qualifying circumstances

CPT 50580 is performed on patients who require renal endoscopy for diagnostic or therapeutic purposes. The procedure is typically indicated when there is a suspected foreign body or calculus in the kidney or renal pelvis. It may also be performed to assess the structures of the renal collecting system or to administer contrast material for radiological examination. The procedure is exclusive of radiologic service, meaning that any radiological imaging performed during the procedure should be reported separately.

5. When to use CPT code 50580

CPT code 50580 should be used when a healthcare provider performs renal endoscopy through nephrotomy or pyelotomy, with or without irrigation, instillation, or ureteropyelography, and removes a foreign body or calculus. It is important to note that this code is exclusive of radiologic service, so any radiological imaging performed during the procedure should be reported separately.

6. Documentation requirements

To support a claim for CPT 50580, the healthcare provider must document the following information:

• Patient’s diagnosis or reason for the procedure
• Details of the procedure performed, including whether irrigation, instillation, or ureteropyelography was performed
• Use of contrast material, if applicable
• Description of any foreign bodies or calculi removed
• Placement of a stent, if applicable
• Details of any additional procedures performed during the same session
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT 50580, ensure that the procedure meets the specific criteria outlined in the code description. It is important to report any additional procedures or services separately, including radiologic imaging. CPT code 50580 should not be reported with codes 50551-50579, as these codes represent different endoscopic procedures on the kidney. It is crucial to follow the specific guidelines provided by the payer and accurately document the procedure to support the billing claim.

8. Historical information

CPT code 50580 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 renal endoscopy through nephrotomy to remove a kidney stone from a patient.
2. During a renal endoscopy procedure, a foreign body is discovered in the renal pelvis and successfully removed by the healthcare provider.
3. A patient undergoes renal endoscopy through pyelotomy to assess the structures of the renal collecting system and administer contrast material for radiological examination.