How To Use CPT Code 50705

CPT 50705 describes the procedure of ureteral embolization or occlusion, including imaging guidance, and all associated radiological supervision and interpretation. This article will cover the description, official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 50705?

CPT 50705 can be used to describe the procedure of ureteral embolization or occlusion. This involves deliberately blocking the ureter, typically to treat a ureterovaginal fistula that was not successfully treated with urinary diversion via a nephrostomy. The procedure includes the use of imaging guidance, such as ultrasound and/or fluoroscopy, and all associated radiological supervision and interpretation.

2. Official Description

The official description of CPT code 50705 is: ‘Ureteral embolization or occlusion, including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation (List separately in addition to code for primary procedure).’ This code should be used in conjunction with other specific codes for the primary procedure.

3. Procedure

1. During the procedure, the healthcare provider uses imaging guidance, such as ultrasound and/or fluoroscopy, to visualize the ureter.
2. The provider deliberately blocks the ureter to prevent the flow of urine into a fistula, such as a ureterovaginal fistula.
3. This can be done by placing specially designed coils to block the ureter or by instilling a tissue glue, such as butyl-2-cyanoacrylate, to seal the ureter.
4. The procedure also includes radiological supervision and interpretation to ensure the correct placement and effectiveness of the occlusion.

4. Qualifying circumstances

CPT 50705 is typically performed when other treatments, such as urinary diversion via a nephrostomy, have been unsuccessful in treating a ureterovaginal fistula. The procedure is performed by a healthcare provider who is experienced in using imaging guidance, such as ultrasound and/or fluoroscopy, to visualize and manipulate the ureter. The occlusion of the ureter is done to block the flow of urine into the fistula and promote healing.

5. When to use CPT code 50705

CPT code 50705 should be used when performing the procedure of ureteral embolization or occlusion, including imaging guidance and radiological supervision and interpretation. It should be used in addition to the primary procedure code that describes the reason for the occlusion. This code should not be reported without an appropriate primary code.

6. Documentation requirements

To support a claim for CPT 50705, the healthcare provider must document the following information:

• The reason for performing the ureteral embolization or occlusion
• The use of imaging guidance, such as ultrasound and/or fluoroscopy
• The specific technique used to block the ureter
• The radiological supervision and interpretation performed during the procedure
• Any complications or additional findings during the procedure
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT 50705, ensure that the procedure is performed by a healthcare provider experienced in using imaging guidance. This code should be reported in addition to the primary procedure code that describes the reason for the ureteral embolization or occlusion. It is important to check with the Medicare provider or private carrier to determine their coverage policies for this procedure. Even if not covered, it should still be reported for statistical purposes. The code includes imaging guidance and radiological supervision and interpretation, so separate coding for these services is not necessary.

8. Historical information

CPT 50705 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 healthcare provider performing ureteral embolization using ultrasound guidance to treat a ureterovaginal fistula.
2. A radiologist using fluoroscopy to guide the placement of coils for ureteral occlusion in a patient with a recurrent ureterovaginal fistula.
3. An interventional radiologist performing ureteral embolization with the use of tissue glue to block the ureter in a patient with a complex ureterovaginal fistula.
4. A urologist using ultrasound and fluoroscopy to guide the placement of coils for ureteral occlusion in a patient with a ureterocutaneous fistula.
5. A nephrologist performing ureteral embolization with the use of tissue glue to block the ureter in a patient with a ureterointestinal fistula.
6. An interventional radiologist using ultrasound guidance to place coils for ureteral occlusion in a patient with a ureterovesical fistula.
7. A urologist performing ureteral embolization with the use of tissue glue to block the ureter in a patient with a ureteropelvic junction obstruction.
8. A radiologist using fluoroscopy to guide the placement of coils for ureteral occlusion in a patient with a ureteral stricture.
9. An interventional radiologist performing ureteral embolization with the use of tissue glue to block the ureter in a patient with a ureteral calculus.
10. A urologist using ultrasound and fluoroscopy to guide the placement of coils for ureteral occlusion in a patient with a ureteral tumor.