AHA Coding Clinic® for HCPCS - 2019 Issue 4; Ask the Editor

Loop ilioscopy and stent exchange

A patient with an ileal conduit for urinary diversion managed by serial ureteral stent exchanges presents for a stent exchange. A flexible cystoscopy was introduced into the stoma and navigated down through the conduit until the ureteral stents were encountered. One of the stents was grasped and brought to the level of the stoma. A guidewire was advanced through the stents with fluoroscopic guidance to the level of the left kidney. The stent was removed and a catheter was advanced over the guidewire. A urinary diversionary stent was advanced to the left kidney and the wire removed. The same procedure was performed on the right kidney. The stents were cut to the level of the stoma and retracted into the urethral stoma. It appears that CPT code 50688 might be the correct code, however the stents are internal. What is the correct code for a loop ileoscopy with stent exchange? ...

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