How To Use CPT Code 50690

CPT 50690 describes the injection procedure for visualization of the ileal conduit and/or ureteropyelography, exclusive of radiologic service. 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 50690?

CPT 50690 can be used to describe the injection procedure performed by a healthcare provider to visualize the ileal conduit and/or ureteropyelography. This procedure involves injecting contrast material through an existing artificial opening into the ureter or renal pelvis to analyze the ileal conduit or through a catheter to analyze the ureter, renal pelvis, and kidney. It is mainly performed to evaluate any defects or abnormal function of the renal collecting system, identify the causes of pain, detect blockages in the ureteropelvic junction, or study the point of the ureter connection to the ileum.

2. Official Description

The official description of CPT code 50690 is: ‘Injection procedure for visualization of ileal conduit and/or ureteropyelography, exclusive of radiologic service.’

3. Procedure

1. The healthcare provider prepares the patient for the procedure, ensuring appropriate prepping and anesthesia.
2. The provider cleanses the skin around the stoma, or opening, with an antibacterial solution.
3. A catheter tube is inserted through the stoma into the ureter or renal pelvis.
4. The provider injects contrast material into the catheter tube, filling the ureter and renal pelvis.
5. Radiographs, or X-rays, are taken to visualize the renal pelvis, ureter, and ileal conduit and locate any filling defects.

4. Qualifying circumstances

CPT 50690 is performed when there is a need to visualize the ileal conduit and/or ureteropyelography. This procedure is typically done to evaluate defects or abnormal function of the renal collecting system, identify causes of pain, detect blockages in the ureteropelvic junction, or study the point of the ureter connection to the ileum. It is important to note that this code is exclusive of radiologic services, which should be reported separately.

5. When to use CPT code 50690

CPT code 50690 should be used when the healthcare provider performs the injection procedure to visualize the ileal conduit and/or ureteropyelography. It is important to ensure that the procedure is performed exclusively for this purpose and not in conjunction with radiologic services. If radiologic supervision and interpretation are required, separate codes should be used.

6. Documentation requirements

To support a claim for CPT 50690, the healthcare provider must document the following information:

• Patient’s condition and the need for the injection procedure
• Specific details of the procedure, including the use of contrast material and the route of injection
• Date and time of the procedure
• Radiographs or X-rays taken and their findings
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT 50690, ensure that the procedure is performed exclusively for visualization of the ileal conduit and/or ureteropyelography. It is important to report this code separately from any radiologic services. If radiologic supervision and interpretation are required, appropriate codes should be used. Review the specific guidelines provided by the payer to ensure accurate billing and reimbursement.

8. Historical information

CPT 50690 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 an injection procedure to visualize the ileal conduit and ureteropyelography in a patient with suspected renal collecting system defects.
2. A patient presents with unexplained pain, and the healthcare provider performs an injection procedure to identify the cause by visualizing the ileal conduit and ureteropyelography.
3. A healthcare provider performs an injection procedure to study the point of the ureter connection to the ileum in a patient with a history of urinary tract abnormalities.
4. A patient with a known blockage in the ureteropelvic junction undergoes an injection procedure to visualize the ileal conduit and ureteropyelography and assess the severity of the obstruction.
5. A healthcare provider performs an injection procedure to detect any urine leakage around the ureter or renal pelvis site in a patient with suspected urinary tract abnormalities.
6. An injection procedure is performed to visualize the ileal conduit and ureteropyelography in a patient with a history of recurrent urinary tract infections.
7. A healthcare provider performs an injection procedure to evaluate the function of the renal collecting system in a patient with suspected renal abnormalities.
8. A patient with a known connection between the ureter and ileum undergoes an injection procedure to assess the integrity of the connection and detect any complications.
9. An injection procedure is performed to visualize the ileal conduit and ureteropyelography in a patient with unexplained hematuria.
10. A healthcare provider performs an injection procedure to study the renal collecting system in a patient with a history of kidney stones.