Summary & Overview
HCPCS C7546: Nephroureteral Catheter Replacement with Ureteral Dilation
HCPCS Level II code C7546 covers the fluoroscopically guided removal and replacement of an externally accessible nephroureteral catheter (external/internal stent) combined with ureteral stricture balloon dilation, including imaging guidance and radiological supervision and interpretation. This procedure is a common interventional radiology service for patients with obstructive uropathy and ureteral strictures, and it affects inpatient and outpatient billing patterns across the country due to its resource intensity and imaging component.
Key payers in this national overview include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find concise benchmarks and operational context for coding and billing this service line, a review of typical clinical settings and utilization drivers, and notes on common procedural elements that influence reimbursement categorization. The summary highlights where this code intersects with interventional radiology and urology practice patterns, and outlines the types of documentation and service locations that most commonly accompany its use.
Data not available in the input for payer-specific rates, associated taxonomies, and ICD-10 diagnoses; the publication focuses on the code definition, service context, and national payer coverage landscape.
Billing Code Overview
HCPCS Level II code C7546 describes the removal and replacement of an externally accessible nephroureteral catheter (for example, an external/internal stent) that requires fluoroscopic guidance, and includes ureteral stricture balloon dilation, imaging guidance, and all associated radiological supervision and interpretation.
Service type: Interventional radiology procedure involving catheter management and endourologic dilation.
Typical site of service: Hospital outpatient department or ambulatory surgical center with fluoroscopic capability; may also be performed in interventional radiology suites.
Data not available in the input for associated taxonomies, specific ICD-10 diagnoses, and related procedural codes.
Clinical & Coding Specifications
Clinical Context
A 66-year-old patient with a history of pelvic malignancy treated with radiation presents with progressive flank pain, recurrent urinary tract infections, and rising serum creatinine. Imaging demonstrates hydronephrosis and an indwelling externally accessible nephroureteral catheter (external/internal stent) with suspected ureteral stricture at the pelvic brim. The interventional radiology team schedules removal and replacement of the existing nephroureteral catheter with fluoroscopic guidance, combined with ureteral stricture balloon dilation during the same session. The clinical workflow includes pre-procedure evaluation (consent, coagulation status, antibiotic prophylaxis as indicated), patient positioning and sterile prep, fluoroscopic localization of the existing catheter, exchange over a guidewire, balloon dilation of the narrowed ureteral segment under fluoroscopy, placement of a new external/internal nephroureteral catheter, and final contrast nephrostogram to confirm drainage. Post-procedure care includes monitoring for hematuria, sepsis, catheter function, and outpatient follow-up for definitive urologic management or catheter maintenance.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when work, time, or technical difficulty substantially exceeds typical for the procedure (document justification). |