Question:

How would you code when a radiologist is asked to create new access, or enlarge an existing access, for a urologist to perform subsequent endourologic procedures?

Answer:

If there is an existing nephrostomy tube or nephroureteral catheter and that tract is enlarged by the radiologist to allow the surgeon to use larger instruments during an endourologic procedure, such as a kidney stone removal, this is reported with code 50436. When there is no existing nephrostomy tube or nephroureteral catheter and the radiologist must create the access as well as dilate the tract for the surgeon, this is reported with code 50437. Some phrases to look for in documentation to identify these procedures include balloon dilator, serial dilators, or sheath.

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