AMA Clinical Examples in Radiology - 2015 Issue 4 (Fall)
Nephrostomy Tube Placement
CLINICAL EXAMPLE 1 Nephrostomy Tube Placement CLINICAL HISTORY 74-year-old female with an obstructing stone in the upper pole of the left kidney. TECHNIQUE After the risks, benefits, and alternatives were explained to the patient, both written and oral consent were obtained. A time-out was performed. The patient was positioned prone on the fluoroscopy table. Fentanyl IV and Versed IV were titrated to moderate sedation. Total sedation time of 45 minutes. 50432 The left flank was prepped and draped in the usual sterile fashion. Lidocaine 1% was instilled subcutaneously for local anesthesia. Under ultrasound guidance, a 21-gauge needle was advanced...
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Article Overview
This article reviews a nephrostomy tube placement example and discusses related CPT changes for genitourinary access, drainage, stent placement, and associated imaging guidance. It is aimed at coders, billing staff, and clinicians who need to understand how the revised CPT framework groups these services and how the updated guidance affects reporting.
Why This Topic Matters
The article helps readers understand a set of CPT revisions that affect nephrostomy and related urinary tract procedures, including bundled reporting and revised terminology. It is relevant for accurate radiology, interventional radiology, and genitourinary procedure coding.
Article Sections
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Clinical Example 1
A worked radiology example involving percutaneous urinary access and catheter placement in the setting of obstructive urologic disease. The section presents the procedural narrative and imaging context for coding review.
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Discussion
A discussion of CPT updates affecting nephrostomy and related genitourinary procedures, including bundled service concepts, revised descriptors, and related guidance from professional organizations.
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Sources
Citations to professional publications and reference materials used in preparing the article.
What You Will Learn
- How the article frames a nephrostomy tube placement example for coding review.
- What broad categories of CPT changes are discussed for genitourinary access and drainage procedures.
- Which professional organizations and reference publications are associated with the guidance.
- How the article situates nephrostomy-related services within updated bundled reporting concepts.
Who Should Read This
- Medical coders
- Radiology coders
- Interventional radiology billing staff
- Urology coding staff
- Clinical documentation staff
Codes Discussed
Code Ranges Discussed
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