Summary & Overview
CPT 50389: Fluoroscopy-Guided Nephrostomy Tube Removal
CPT code 50389 captures the fluoroscopy-guided removal of a nephrostomy tube from the renal collecting system when the tube is no longer needed for urinary drainage. This code is relevant to interventional radiology and urology practices and matters nationally because nephrostomy tube management is a common component of care for patients with urinary obstruction, postoperative drainage needs, or complex genitourinary conditions.
Key payers in scope include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of the clinical context of the service, typical sites of care, and the primary administrative considerations associated with billing this procedure. The publication summarizes common modifiers used with this service and highlights where data is available or not in the input.
The report provides benchmarks and coding guidance context where available, outlines typical clinical scenarios for nephrostomy tube removal, and notes payor coverage considerations at a national level. Data not available in the input include specific ICD-10 diagnoses, associated taxonomies, related codes, and payer-specific reimbursement rates.
Billing Code Overview
CPT code 50389 describes the removal of a nephrostomy tube from the renal collecting system when it is no longer required for urinary drainage. The procedure is performed with the use of fluoroscopy when an indwelling ureteral stent or other condition necessitates image guidance.
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Service type: Image-guided removal of a percutaneous nephrostomy tube
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Typical site of service: Interventional radiology suite, ambulatory surgery center, or hospital outpatient setting
Clinical & Coding Specifications
Clinical Context
A 62-year-old male with a history of obstructive uropathy secondary to ureteral stricture underwent percutaneous nephrostomy tube placement for urinary drainage. After several weeks of therapy and confirmation of ureteral patency by antegrade nephrostogram under fluoroscopy, the interventional radiologist schedules removal of the nephrostomy tube. The procedure is performed in an outpatient interventional radiology suite or hospital radiology department using fluoroscopic guidance to confirm that no residual obstruction or leak exists and that an indwelling ureteral stent (if present) will maintain drainage. The patient is positioned, monitoring is applied, the existing catheter is prepped and connected for contrast injection to confirm free drainage into the bladder, and the catheter is removed over a guidewire or by simple traction when appropriate. Post-procedure instructions include observation for hematuria, flank pain, fever, and instruction for return precautions. Typical documentation includes site, laterality, indication, fluoroscopy use, contrast study findings, any complications, and disposition.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | When billing physician/nonfacility professional component separate from facility technical component |
52 |