How To Use CPT Code 50974

CPT 50974 describes the procedure of ureteral endoscopy through ureterotomy, 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 50974?

CPT 50974 can be used to describe the procedure of ureteral endoscopy through ureterotomy. This involves the examination of the kidney, renal pelvis, and ureters by incising the ureter and passing an endoscope through it to view the structures. The procedure may also include biopsy of tissue. It is typically performed for the removal of ureteral stones.

2. Official Description

The official description of CPT code 50974 is: ‘Ureteral endoscopy through ureterotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with biopsy.’

3. Procedure

1. The provider prepares the patient and administers anesthesia.
2. An incision is made in the patient’s flank or side to access the ureter.
3. An endoscope is inserted through the incision and passed through the ureter into the kidney or renal pelvis.
4. The provider may use irrigation or instillation techniques to clear the visual field or introduce contrast material for ureteropyelography.
5. If necessary, the provider performs a biopsy of suspicious sites using instruments in the endoscope.
6. After the procedure, the endoscope is removed, the ureter incision is sutured, a drainage tube may be inserted, and the wound is closed in layers.

4. Qualifying circumstances

CPT 50974 is performed on patients who require ureteral endoscopy through ureterotomy. This procedure is typically indicated for the removal of ureteral stones. The patient must be appropriately prepped and anesthetized. The provider must have the necessary expertise to perform the procedure and interpret the findings.

5. When to use CPT code 50974

CPT code 50974 should be used when the provider performs ureteral endoscopy through ureterotomy, with or without irrigation, instillation, or ureteropyelography, and includes a biopsy. It is important to ensure that the procedure meets the specific criteria outlined in the code description.

6. Documentation requirements

To support a claim for CPT 50974, the provider must document the following information:

• Patient’s diagnosis and the medical necessity for the procedure
• Details of the procedure performed, including the approach, use of irrigation or instillation, and any ureteropyelography
• Date and duration of the procedure
• Findings from the endoscopic examination, including any biopsies performed
• Any additional procedures or interventions performed during the same session
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 50974, ensure that the procedure meets the specific criteria outlined in the code description. It is important to accurately document the details of the procedure and provide any necessary supporting documentation. Additionally, be aware of any bundling or unbundling rules that may apply to the specific circumstances of the procedure.

8. Historical information

CPT 50974 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 urologist performs ureteral endoscopy through ureterotomy with biopsy for a patient with a suspected ureteral stone.
2. A patient with recurrent urinary tract infections undergoes ureteral endoscopy through ureterotomy with biopsy to investigate the cause of the infections.
3. A urologist performs ureteral endoscopy through ureterotomy with biopsy and ureteral stent placement for a patient with a ureteral stricture.
4. A patient with hematuria undergoes ureteral endoscopy through ureterotomy with biopsy to evaluate the source of the bleeding.
5. A urologist performs ureteral endoscopy through ureterotomy with biopsy and lithotripsy for a patient with a large ureteral stone.
6. A patient with recurrent kidney stones undergoes ureteral endoscopy through ureterotomy with biopsy and ureteral dilation.
7. A urologist performs ureteral endoscopy through ureterotomy with biopsy and ureteropyelography for a patient with suspected upper urinary tract abnormalities.
8. A patient with a history of ureteral strictures undergoes ureteral endoscopy through ureterotomy with biopsy and ureteral stent placement.