How To Use CPT Code 50684

CPT 50684 describes the injection procedure for ureterography or ureteropyelography through a ureterostomy or indwelling ureteral catheter. 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 50684?

CPT 50684 can be used to describe the injection procedure for ureterography or ureteropyelography through a ureterostomy or indwelling ureteral catheter. This code is used when the provider injects contrast material through an existing ureteral catheter or a previously created opening between the skin and ureter. The purpose of this procedure is to evaluate the ureterostomy tube for any defects or abnormal functioning, or to identify symptoms related to pain, blockage, or urine leakage around the ureterostomy tube insertion site.

2. Official Description

The official description of CPT code 50684 is: ‘Injection procedure for ureterography or ureteropyelography through ureterostomy or indwelling ureteral catheter.’

3. Procedure

1. The provider prepares the patient for the procedure, ensuring appropriate prepping and anesthesia.
2. The provider washes the skin around the ureterostomy tube insertion site with an antibacterial solution.
3. The provider disconnects the ureterostomy drainage bag.
4. The provider injects contrast material using a syringe into the ureterostomy tube.
5. The provider injects the contrast material slowly through the tube into the ureter and renal pelvis.
6. Once the ureter and renal pelvis are filled with contrast, the provider obtains X-ray imaging of the ureter and renal pelvis.

4. Qualifying circumstances

Patients eligible for CPT 50684 are those who require evaluation of the ureterostomy tube for defects or abnormal functioning, or those who exhibit symptoms related to pain, blockage, or urine leakage around the ureterostomy tube insertion site. The procedure is performed by a provider and involves the injection of contrast material through a ureterostomy or indwelling ureteral catheter.

5. When to use CPT code 50684

CPT code 50684 should be used when the provider performs the injection procedure for ureterography or ureteropyelography through a ureterostomy or indwelling ureteral catheter. It should not be reported in conjunction with other specific codes (50433, 50434, 50693, 50694, 50695). For radiological supervision and interpretation, use code 74425.

6. Documentation requirements

To support a claim for CPT 50684, the provider must document the following information:

• Patient’s diagnosis or symptoms indicating the need for the procedure
• Details of the injection procedure, including the use of contrast material
• Date and time of the procedure
• Results of the X-ray imaging of the ureter and renal pelvis
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 50684, ensure that the procedure is performed by a qualified provider and involves the injection of contrast material through a ureterostomy or indwelling ureteral catheter. Do not report CPT 50684 in conjunction with specific codes (50433, 50434, 50693, 50694, 50695). For radiological supervision and interpretation, use code 74425.

8. Historical information

CPT 50684 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates to the code since its addition.

9. Examples

1. A provider performs an injection procedure for ureterography through an indwelling ureteral catheter to evaluate the functioning of the ureterostomy tube in a patient with recurrent urinary tract infections.
2. A provider injects contrast material through a previously created opening between the skin and ureter to perform ureteropyelography and identify the cause of persistent pain in a patient with a ureterostomy.
3. A provider performs an injection procedure for ureterography through an indwelling ureteral catheter to assess the presence of urine leakage around the ureterostomy tube insertion site in a patient with a history of ureteral injury.
4. A provider injects contrast material through a ureterostomy tube to perform ureteropyelography and evaluate the functioning of the ureterostomy in a patient with suspected blockage.
5. A provider performs an injection procedure for ureterography through an indwelling ureteral catheter to identify any defects or abnormalities in the ureterostomy tube in a patient with recurrent urinary incontinence.
6. A provider injects contrast material through a previously created opening between the skin and ureter to perform ureteropyelography and assess the patency of the ureterostomy tube in a patient with a history of ureteral strictures.
7. A provider performs an injection procedure for ureterography through an indwelling ureteral catheter to evaluate the functioning of the ureterostomy tube in a patient with recurrent kidney stones.