Genitourinary IR – Same Procedure, Different Terms

With interventional radiology procedures, to say physician documentation can be a little tricky is an understatement. For genitourinary procedures specifically, this seems even more apparent. It’s not uncommon for different physicians to describe the same procedure in different ways and, with some terms used interchangeably (that have very different meanings) it can be frustrating for anyone coding genitourinary services. Let’s clarify some of the confusion when it comes to tackling this challenge.  

Catheters and Stents 

Traditionally, “catheter” and “stent” have been used somewhat interchangeably. However, for genitourinary procedure codes these terms have separate, distinct meanings

  • Stent is used for a completely internal device; no portion remains outside the body. 
  • Catheter indicates that a portion does remain outside the body. The documentation must be clear so the correct code may be assigned, despite the term used by the physician.  

For example, if the documentation describes the placement of a nephroureteral stent that has one end in the bladder and the other connected to a drainage bag, this would be coded as a nephroureteral catheter placement, not a stent placement, despite the use of the term stent. 

Common Terms for Therapeutic Procedures 

With the variety of terms used by physicians to document the same genitourinary procedures, it can be challenging to keep track of which procedure a term is referring to. Some of the more common terms you may see in the documentation are illustrated below: 

CPT Code(s)ProcedureOther Terms Used
50693 -50695Placement of a ureteral stent (completely internal device)• J-J stents
• Pigtail stents
• Double-J stent
• Double pigtail stent
50433Placement of a nephroureteral drainage catheter that combines a ureteral catheter and a nephrostomy catheter into a single catheter for external and/or internal drainage• Internal/external catheter
• Nephroureteral catheter
• Nephroureteral stent
• Universal stent
50432Percutaneous placement of a nephrostomy tube into the kidney for drainage• Perc neph
• Percutaneous nephrostomy
50690 + 74425Ureterostomy – the ureters are detached from the bladder and attached directly to a stoma in the abdominal wall• Loopogram
• Ileal loop study

While not comprehensive, hopefully this list can ease some of the frustration of the different terminology used for GU procedures for more confident coding. 

Master coding for genitourinary IR procedures 

Join us Wednesday, April 15 for the next installment of our 11-part interventional radiology coding series, featuring prominent interventional radiology coding expert Jeff Majchrzak, BA, RCC, CIRCC. This two-hour session covers common, and not so common, scenarios that create challenges for coders and frequently asked questions pertaining to genitourinary imaging and interventions.