AMA Clinical Examples in Radiology - 2006 Issue 3 (Summer)
Nephrostogram
Nephrostogram Clinical History Ureteral stricture with hydronephrosis related to obstruction Procedure Diagnostic nephrostogram was performed initially through an existing nephrostomy tube. The existing nephrostomy site is infiltrated with 1% lidocaine for local anesthesia. The nephrostomy tube is removed over a straight guidewire. A wire is advanced down the left ureter to cross the ureteral occlusion with catheter and wire passed to the 50394 74425 urinary bladder under fluoroscopy. 30 mL of 1% lidocaine is instilled into the urinary bladder with dilute contrast. The distance from the urinary bladder to the left renal pelvis is measured on the guidewire. An...
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Article Overview
This article explains the coding context for a nephrostogram case involving urinary tract obstruction, antegrade access through an existing nephrostomy route, ureteral stent placement, balloon dilation, and associated imaging and sedation services. It is useful for radiology coders, interventional radiology staff, and reimbursement professionals who need to understand how the case is documented and which code sets are referenced in the example.
Why This Topic Matters
The page helps readers identify the relevant procedure categories and code families discussed in a real-world urinary interventional radiology example, while clarifying that the article is centered on coding documentation and service attribution.
Article Sections
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Clinical History
Summarizes the patient context and the urinary tract issue prompting the study.
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Procedure
Describes the interventional urinary tract procedure workflow, including access, imaging, and stent-related steps.
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Comment
Provides the post-procedure clinical interpretation and status of the collecting system and obstruction.
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Medications
Lists medications used during the case and notes monitored sedation.
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Impression
Summarizes the imaging and procedural findings after the intervention.
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How to Code
Presents the coding discussion for the nephrostogram example and the related radiology and sedation code families.
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Discussion
Offers a brief general statement about the purpose of nephrostogram studies.
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Coding Tips
Reviews general coding guidance and documentation considerations related to urinary procedures and interventional radiology services.
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Endnotes
Lists a cited source related to coding guidance and procedural descriptions.
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References
Provides reference citations supporting the article's coding discussion.
What You Will Learn
- The general structure of a nephrostogram case in interventional radiology.
- Which urinary procedure code families are discussed in the example.
- How the article frames imaging supervision, stent placement, dilation, and sedation within the coding discussion.
- What kinds of documentation and reference materials the article uses to support coding interpretation.
Who Should Read This
- Radiology coders
- Interventional radiology staff
- Revenue cycle and reimbursement teams
- Coding educators
- Physician documentation reviewers
Codes Discussed
Code Ranges Discussed
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