How To Use CPT Code 50606

CPT 50606 describes the endoluminal biopsy of the ureter and/or renal pelvis, performed by a non-endoscopic approach using imaging guidance. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 50606?

CPT 50606 can be used to describe the endoluminal biopsy of the ureter and/or renal pelvis. Unlike endoscopic procedures, this code is used when the biopsy is performed through another route, such as a nephrostomy catheter. The procedure is guided by imaging technologies, such as ultrasound and/or fluoroscopy, and includes all associated radiological supervision and interpretation.

2. Official Description

The official description of CPT code 50606 is: ‘Endoluminal biopsy of ureter and/or renal pelvis, non-endoscopic, including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation (List separately in addition to code for primary procedure).’ It is important to note that this code should be used in conjunction with specific primary procedure codes and should not be reported with certain other codes.

3. Procedure

1. The provider accesses the ureter and/or renal pelvis through a route such as a nephrostomy catheter.
2. Imaging guidance, such as ultrasound and/or fluoroscopy, is used to guide the procedure.
3. The provider uses an instrument, such as a brush, to obtain cells for diagnostic analysis from the inner wall of the ureter or renal pelvis.
4. The instruments are withdrawn, and the procedure is completed.

4. Qualifying circumstances

CPT 50606 is performed on patients who require a biopsy of the ureter and/or renal pelvis. It is important to note that this code is specifically for non-endoscopic procedures and should not be used for endoscopic procedures on the ureter. The procedure must be performed using imaging guidance, such as ultrasound and/or fluoroscopy, and includes all associated radiological supervision and interpretation.

5. When to use CPT code 50606

CPT code 50606 should be used when a non-endoscopic biopsy of the ureter and/or renal pelvis is performed using imaging guidance. It is important to ensure that the procedure meets the specific criteria outlined in the code description and is not performed in conjunction with certain other codes.

6. Documentation requirements

To support a claim for CPT 50606, the provider must document the following information:

• Specific details of the procedure performed, including the route of access and the use of imaging guidance
• Date and time of the procedure
• Any associated radiological supervision and interpretation
• Any additional relevant information, such as the reason for the biopsy and any findings

7. Billing guidelines

When billing for CPT 50606, ensure that the procedure meets the specific criteria outlined in the code description. It is important to use the appropriate primary procedure code in conjunction with CPT 50606. Additionally, be aware of the codes that should not be reported with CPT 50606. Follow CPT and payer-specific guidelines for accurate and appropriate billing.

8. Historical information

CPT 50606 was added to the Current Procedural Terminology system on January 1, 2016. There have been no updates to the code since its addition.

9. Examples

1. A patient undergoes a non-endoscopic biopsy of the renal pelvis using ultrasound guidance.
2. A provider performs an endoluminal biopsy of the ureter and renal pelvis through a nephrostomy catheter, guided by fluoroscopy.
3. Imaging guidance is used to perform a non-endoscopic biopsy of the ureter, obtaining cells for diagnostic analysis.
4. A patient undergoes a non-endoscopic biopsy of the renal pelvis, with associated radiological supervision and interpretation.
5. A provider performs an endoluminal biopsy of the ureter and renal pelvis, using both ultrasound and fluoroscopy for guidance.
6. Imaging technologies, such as ultrasound and fluoroscopy, are used to guide a non-endoscopic biopsy of the ureter and renal pelvis.
7. A patient undergoes a non-endoscopic biopsy of the renal pelvis, with all associated radiological supervision and interpretation.
8. A provider performs an endoluminal biopsy of the ureter, using imaging guidance to obtain cells for diagnostic analysis.
9. Imaging guidance, such as fluoroscopy, is used to perform a non-endoscopic biopsy of the renal pelvis.
10. A patient undergoes a non-endoscopic biopsy of the ureter and renal pelvis, with associated radiological supervision and interpretation.