Ask a Rev Cycle Expert: Bilateral Exchange Nephrostomy Drains?
If a provider would need to perform a bilateral percutaneous exchange of nephrostomy drains, and during the same procedure using the same percutaneous access, also perform bilateral exchange of ureteral occlusion balloon catheters (to divert urinary flow from the bladder), would we report 50435 for each side - 50435 with modifier 50? Which CPT® would you recommend to report the bilateral percutaneous exchange of ureteral occlusion balloon catheters? Or would this be considered part of the nephrostomy drains exchange and not separately reported?
Current Procedural Terminology (CPT®) code 50435 Exchange nephrostomy catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation with modifier 50 Bilateral Procedure may be reported for the bilateral nephrostomy drain change. For the balloon catheters, consider reporting CPT® code 50705 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).
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