How To Use CPT Code 50955

CPT 50955 describes the procedure of ureteral endoscopy through an established ureterostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service. 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 50955?

CPT 50955 can be used to describe the procedure of ureteral endoscopy through an established ureterostomy. This code is used when a healthcare provider examines the kidney, renal pelvis, and ureter using an endoscope, which is passed through a previously constructed external opening on the skin into the ureter. The procedure may involve irrigation, instillation, or ureteropyelography, but does not include radiologic services.

2. Official Description

The official description of CPT code 50955 is: ‘Ureteral endoscopy through established ureterostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with biopsy.’

3. Procedure

1. The healthcare provider prepares the patient for the procedure, ensuring appropriate prepping and anesthesia.
2. The provider inserts an endoscope through a previously constructed external opening on the skin into the ureter.
3. A guide wire is passed into the opening, and the ureterostomy tube, if present, is removed.
4. The endoscope is then advanced into the kidney or renal pelvis.
5. The provider may perform irrigation by flushing the area with saline to clear the visual field.
6. Alternatively, the provider may use instillation, introducing fluid by drops.
7. Ureteropyelography may be performed by introducing contrast material into the area for X-ray imaging of the structures.
8. A small specimen may be removed from the lumen for biopsy.
9. After the examination is complete, the provider removes the endoscope and guide wire instruments.
10. The ureterostomy tube is reinserted or the passage is allowed to close by itself.

4. Qualifying circumstances

Patients eligible for CPT 50955 are those who require ureteral endoscopy through an established ureterostomy for the diagnosis of ureteral lesions. The procedure is performed by a healthcare provider using an endoscope, and may involve irrigation, instillation, or ureteropyelography. It is important to note that radiologic services are not included in this code.

5. When to use CPT code 50955

CPT code 50955 should be used when a healthcare provider performs ureteral endoscopy through an established ureterostomy, with or without irrigation, instillation, or ureteropyelography. It is important to ensure that the procedure does not involve radiologic services, as they are not included in this code.

6. Documentation requirements

To support a claim for CPT 50955, the healthcare provider must document the following information:

• Patient’s diagnosis and the need for ureteral endoscopy through an established ureterostomy
• Details of the procedure performed, including any irrigation, instillation, or ureteropyelography
• Date and duration of the procedure
• Any biopsy performed and the results, if available
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT 50955, ensure that the procedure involves ureteral endoscopy through an established ureterostomy, with or without irrigation, instillation, or ureteropyelography. It is important to note that radiologic services are not included in this code. There are no specific guidelines regarding reporting CPT 50955 with other codes.

8. Historical information

CPT 50955 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 healthcare provider performs ureteral endoscopy through an established ureterostomy, with irrigation, to examine the renal pelvis and ureter of a patient with suspected ureteral lesions.
2. During a procedure, a healthcare provider performs ureteral endoscopy through an established ureterostomy, with instillation, to visualize the renal pelvis and ureter of a patient with recurrent urinary tract infections.
3. A healthcare provider performs ureteral endoscopy through an established ureterostomy, with ureteropyelography, to obtain X-ray images of the renal pelvis and ureter for a patient with suspected abnormalities.
4. During a procedure, a healthcare provider performs ureteral endoscopy through an established ureterostomy, with biopsy, to obtain a tissue sample for further examination in a patient with suspected ureteral cancer.
5. A healthcare provider performs ureteral endoscopy through an established ureterostomy, without irrigation, instillation, or ureteropyelography, to assess the condition of the renal pelvis and ureter in a patient with a history of ureteral strictures.