How To Use CPT Code 50693

CPT 50693 describes the placement of a ureteral stent using a pre-existing nephrostomy tract, with the guidance of ultrasound and/or fluoroscopy. 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 50693?

CPT 50693 is used to describe the placement of a ureteral stent using a pre-existing nephrostomy tract. This procedure involves the insertion of a thin tube into a ureter to prevent obstruction or maintain urine drainage from the kidney. The placement of the stent is guided by ultrasound and/or fluoroscopy, which provide live images on a video monitor to assist the healthcare provider during the procedure.

2. Official Description

The official description of CPT code 50693 is: ‘Placement of ureteral stent, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological supervision and interpretation; pre-existing nephrostomy tract.’

3. Procedure

1. The healthcare provider accesses the ureter through a previously placed nephrostomy tract.
2. Using ultrasound and/or fluoroscopy, the provider guides the placement of the ureteral stent into the ureter.
3. If necessary, the provider may inject contrast material to enhance visualization of the renal pelvis and/or ureters and acquire images for later review.

4. Qualifying circumstances

CPT 50693 is performed when there is a pre-existing nephrostomy tract, which is an artificial pathway created between the kidney and the outside of the body to allow urine drainage from the renal pelvis. The procedure requires the use of ultrasound and/or fluoroscopy for guidance. The provider may also perform a diagnostic nephrostogram and/or ureterogram, which involves injecting contrast material to image the internal structures of the kidney and ureter.

5. When to use CPT code 50693

CPT code 50693 should be used when a ureteral stent is placed using a pre-existing nephrostomy tract, with the guidance of ultrasound and/or fluoroscopy. It is important to note that this code is specifically for cases where the nephrostomy tract is already in place. If a new access route is used, different codes should be reported.

6. Documentation requirements

To support a claim for CPT 50693, the healthcare provider must document the following information:

• Confirmation of the pre-existing nephrostomy tract
• Use of ultrasound and/or fluoroscopy for guidance
• Injection of contrast material, if performed
• Date and duration of the procedure
• Any additional findings or complications
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT 50693, ensure that the procedure meets the specific criteria outlined in the code description. It is important to note that this code includes imaging guidance and radiological supervision and interpretation, so separate coding for these services is not necessary. Review CPT and payer-specific guidelines for any additional requirements or considerations when reporting this code.

8. Historical information

CPT 50693 was added to the Current Procedural Terminology system on January 1, 2016. There have been no updates or changes to the code since its addition.

9. Examples

1. A patient with a pre-existing nephrostomy tract undergoes the placement of a ureteral stent using ultrasound guidance.
2. During the procedure, the healthcare provider performs a diagnostic nephrostogram to visualize the internal structures of the kidney and ureter.
3. A fluoroscopy-guided placement of a ureteral stent is performed for a patient with a pre-existing nephrostomy tract.
4. The healthcare provider uses ultrasound and fluoroscopy to guide the placement of a ureteral stent in a patient with a pre-existing nephrostomy tract.
5. During the procedure, the provider injects contrast material to enhance visualization of the renal pelvis and ureters.
6. A patient with a pre-existing nephrostomy tract undergoes the placement of a ureteral stent using fluoroscopy guidance.
7. The healthcare provider performs a diagnostic ureterogram to image the internal structures of the ureter during the placement of a ureteral stent in a patient with a pre-existing nephrostomy tract.
8. A patient with a pre-existing nephrostomy tract undergoes the placement of a ureteral stent using ultrasound and fluoroscopy guidance.
9. The healthcare provider performs a diagnostic nephrostogram and ureterogram to assess the condition of the kidney and ureter during the placement of a ureteral stent in a patient with a pre-existing nephrostomy tract.
10. A fluoroscopy-guided placement of a ureteral stent is performed for a patient with a pre-existing nephrostomy tract, with the injection of contrast material for enhanced visualization.