CPT® Code 50385

Removal (via snare/capture) and replacement of internally dwelling ureteral stent via transurethral approach, without use of cystoscopy, including radiological supervision and interpretation

The procedure described by CPT® Code 50385 involves the removal and replacement of an internally dwelling ureteral stent using a transurethral approach, specifically without the use of cystoscopy. An internally dwelling ureteral stent is a medical device designed to maintain the patency of the ureter, which is the tube that carries urine from the kidney to the bladder. This stent is typically a soft, hollow tube, approximately the size of a strand of spaghetti, and is utilized in cases where there is an obstruction or blockage that prevents normal urine flow. The stent is usually left in place temporarily, often for a duration ranging from a few weeks to several months, until the underlying obstruction is resolved. During the procedure, a catheter is inserted into the bladder, and a contrast agent is injected to enhance visualization of the ureter and stent under fluoroscopic guidance. A guidewire is then advanced into the bladder, and the initial catheter is replaced with a larger one to facilitate the removal of the stent. A snare or capture device is introduced to grasp the distal pigtail portion of the stent, allowing it to be pulled into the bladder and urethra for removal. Following the removal of the old stent, a new stent is positioned appropriately within the ureter, ensuring that the proximal pigtail is located in the renal pelvis and the distal pigtail is situated in the bladder. The correct placement of the new stent is confirmed through fluoroscopy and X-ray imaging, which documents the successful completion of the procedure. This comprehensive approach ensures that the ureter remains open, allowing for the proper drainage of urine and alleviating any obstructions present.