How To Use CPT Code 50694

CPT 50694 describes the placement of a ureteral stent through a new access route, using imaging guidance and all associated radiological supervision and interpretation. 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 50694?

CPT 50694 can be used to describe the placement of a ureteral stent through a new access route, using imaging guidance and all associated radiological supervision and interpretation. This code is used when a provider creates an access route into the ureter, typically to prevent obstruction or maintain drainage of urine, by inserting a ureteral stent. The procedure includes the use of imaging technologies, such as ultrasound and/or fluoroscopy, to guide the placement of the stent.

2. Official Description

The official description of CPT code 50694 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; new access, without separate nephrostomy catheter.’

3. Procedure

1. The provider prepares the patient for the procedure and ensures appropriate anesthesia.
2. Using imaging guidance, such as ultrasound or fluoroscopy, the provider makes a small incision in the skin and inserts a needle introducer into the ureter.
3. A guide wire is then inserted through the needle and advanced past the obstruction in the ureter.
4. The provider advances the ureteral stent over the guide wire and expands it to open up the ureter and relieve the obstruction.
5. If necessary, the provider may inject contrast material to enhance visualization and acquire images for later review.
6. Once the stent is in place, the guide wire is withdrawn.

4. Qualifying circumstances

CPT 50694 is used for patients who require the placement of a ureteral stent through a new access route. This procedure is typically performed when there is a narrowing or obstruction in the ureter that needs to be relieved. The use of imaging guidance, such as ultrasound or fluoroscopy, is necessary to ensure accurate placement of the stent. It is important to note that this code is specifically for cases where a separate nephrostomy catheter is not placed.

5. When to use CPT code 50694

CPT code 50694 should be used when a provider performs the placement of a ureteral stent through a new access route, using imaging guidance and all associated radiological supervision and interpretation. This code should not be used when a separate nephrostomy catheter is placed, as that would require a different code (CPT 50695).

6. Documentation requirements

To support a claim for CPT 50694, the provider must document the following information:

• Reason for the procedure and the need for a ureteral stent
• Details of the imaging guidance used, such as ultrasound or fluoroscopy
• Date of the procedure and the start and end times
• Specific steps taken during the procedure, including the insertion of the needle introducer, guide wire, and stent
• Use of contrast material, if applicable
• Any complications or additional procedures performed
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 50694, ensure that the procedure meets the criteria for this code, including the placement of a ureteral stent through a new access route without a separate nephrostomy catheter. It is important to review CPT and payer-specific guidelines for any additional requirements or modifiers that may be necessary for accurate billing.

8. Historical information

CPT 50694 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 urologist performing the placement of a ureteral stent through a new access route for a patient with ureteral obstruction.
2. An interventional radiologist using imaging guidance to place a ureteral stent for a patient with a narrowing in the ureter.
3. A nephrologist performing the placement of a ureteral stent through a new access route for a patient with urinary tract obstruction.
4. An oncologist using imaging guidance to place a ureteral stent for a patient with a tumor causing ureteral obstruction.
5. A urological surgeon performing the placement of a ureteral stent through a new access route for a patient with recurrent kidney stones.
6. An interventional radiologist using ultrasound guidance to place a ureteral stent for a patient with a congenital ureteral abnormality.
7. A urologist performing the placement of a ureteral stent through a new access route for a patient with ureteral stricture.
8. An interventional radiologist using fluoroscopy guidance to place a ureteral stent for a patient with a ureteral injury.
9. A nephrologist performing the placement of a ureteral stent through a new access route for a patient with a urinary tract infection.