Summary & Overview
CPT 50684: Contrast Study of Ureterostomy Tube and Renal Pelvis
CPT code 50684 represents a diagnostic radiologic procedure in which contrast is injected through an existing ureteral catheter or a skin-to-ureter tract to obtain X‑ray images of the ureter and renal pelvis. This service is used to evaluate ureterostomy tubes for defects, impaired function, obstruction, pain etiology, or urine leakage at the insertion site. The code applies to targeted contrast studies performed by urology or interventional radiology teams and is relevant for hospitals, ambulatory surgery centers, and outpatient radiology settings nationwide.
Key payers in the scope of this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context, typical sites of service, and payer relevance. The brief covers billing context and common modifiers list, and highlights what to expect in claims processing and documentation needs for this diagnostic contrast procedure. Where specific benchmark or policy details are not provided in the input, the summary indicates that data are not available in the input. This material supports billing managers, coding professionals, and clinical administrators seeking a clear, national-level description of CPT code 50684 and its primary clinical use.
Billing Code Overview
CPT code 50684 describes a radiologic procedure in which contrast material is injected through an indwelling ureteral catheter or a previously created skin-to-ureter opening to evaluate the ureterostomy tube and the renal collecting system. The provider performs a separately reportable X‑ray examination of the ureter and renal pelvis to assess for tube defects, abnormal tube function, pain sources, blockage, or urine leakage around the ureterostomy insertion site.
-
Service type: Diagnostic contrast injection with targeted fluoroscopic/radiographic evaluation of the ureter and renal pelvis.
-
Typical site of service: Hospital outpatient radiology suite or ambulatory surgical center; may also occur in specialized interventional radiology or urology procedure rooms.
Clinical & Coding Specifications
Clinical Context
A 68-year-old patient with a long-standing ileal conduit and an indwelling ureterostomy tube presents with new onset flank pain, peristomal leakage of urine, and intermittent fever. The urology team assesses for obstruction, tube integrity, and potential urine extravasation. The procedure 50684 (retrograde injection of contrast through an existing ureteral/ureterostomy catheter with separately reportable radiographic imaging of the ureter and renal pelvis) is performed in an outpatient radiology suite or endoscopy/procedure room equipped for fluoroscopy. The workflow includes verification of the existing catheter or stoma access, aseptic preparation, injection of contrast through the catheter with fluoroscopic imaging to visualize the ureter and renal pelvis, documentation of findings (obstruction, leak, malposition, or stricture), and post-procedure monitoring for complications such as infection or contrast reaction. The typical site of service is an outpatient hospital radiology or ambulatory surgery/procedure center; inpatient performance may occur for hospitalized patients requiring diagnostic evaluation of ureterostomy function.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
52 | Reduced services | When the diagnostic portion or extent is reduced compared with full CPT 50684 service |
53 | Discontinued procedure | If the procedure is started but terminated for patient-related reasons before completion |
59 | Distinct procedural service | When a separate, distinct non-overlapping procedure is performed on the same day |
62 | Two surgeons | When two surgeons work together as primary surgeons during a complex urologic procedure involving the ureterostomy |
76 | Repeat procedure by same physician (note: not in provided list) | Data not available in the input. |
78 | Unplanned return to the operating/procedure room by the same physician following initial procedure for a related procedure during the postoperative period | For unplanned reintervention related to 50684 complications |
80 | Assistant surgeon | When a surgical assistant is required during a related operative procedure |
51 | Multiple procedures | When 50684 is one of multiple procedures performed in the same session |
22 | Increased procedural services | When the procedure requires substantially greater effort, time, or complexity than typical |
23 | Unusual anesthesia requirement | When general anesthesia or deep sedation is required for a patient who normally would not need it |
50 | Bilateral procedure | Not commonly applicable to 50684 but used if bilateral distinct studies are performed |
59 | Distinct procedural service | (Duplicate listing avoided) See first 59 entry |
62 | Two surgeons | (Duplicate) See prior 62 entry |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
2080P0800X | Urology | Urologists commonly perform access, assessment, and interpretation related to ureterostomy studies |
208VP0007X | Nephrology | Nephrologists may be involved in management of obstructive uropathy and imaging interpretation |
261QP0800X | Radiology | Diagnostic and fluoroscopic imaging performed by radiologists in outpatient/inpatient settings |
208D00000X | Physical Medicine & Rehabilitation (note: less common) | Involved in postoperative functional assessment when indicated |
363L00000X | General Surgery | General surgeons who perform stoma or urinary diversion revisions may request this study |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
N13.6 | Pyonephrosis | Evaluation for obstruction and drainage through ureterostomy catheter |
N13.8 | Other obstructive and reflux uropathy | Common indication to assess patency and function of ureterostomy tube |
N32.89 | Other specified disorders of bladder | When conduit/bladder dysfunction is suspected to affect ureterostomy performance |
R31.0 | Gross hematuria | Hematuria may prompt imaging of the collecting system via existing catheter |
N39.0 | Urinary tract infection, site not specified | Infection signs with an indwelling ureterostomy catheter often trigger contrast study |
T83.4XXA | Mechanical complication of other urinary device, implant and graft, initial encounter | Used when there is suspected tube malfunction, leakage, or dislodgement |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
52000 | Cystourethroscopy, with or without collection of specimen(s) by brush or biopsy, with or without dilation (separate procedure) | Performed before or after 50684 when endoscopic evaluation of the bladder or conduit is required |
51701 | Insertion of temporary indwelling ureteral stent (eg, Gibbons or DJ stent) | May be performed after imaging with 50684 if obstruction requiring stent placement is identified |
74445 | Radiologic examination, ureteral and/or renal pelvis, with contrast material via retrograde, with or without KUB radiographs | Radiologic imaging codes often reported in conjunction with the contrast injection described in 50684 |
50700 | Ureteral catheterization, open; simple | Surgical catheter-related procedures that may be part of management when 50684 identifies mechanical issues |
99213 | Office or other outpatient visit for evaluation and management, established patient | Typical E/M code for pre-procedure evaluation or post-procedure follow-up in outpatient setting |