CPT® Code 50562

Renal endoscopy through established nephrostomy or pyelostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with resection of tumor

The procedure described by CPT® Code 50562 involves a renal endoscopy performed through an already established nephrostomy or pyelostomy. This procedure is specifically designed for the examination and treatment of tumors located within the kidney. The process begins with the removal of the external drainage bag from the nephrostomy or pyelostomy tube, which is a tube inserted to allow urine to drain from the kidney. A guidewire is then advanced through this tube, facilitating the removal of the tube itself. Following this, a series of dilators are utilized to expand the tract, enabling the insertion of a renal endoscope. This endoscope allows for direct visualization of the kidney, where the physician can locate the tumor. During the procedure, sterile saline or other solutions may be used for irrigation, and diagnostic or therapeutic solutions can be instilled into the kidney. Additionally, contrast material may be introduced for ureteropyelography, which is a separate radiologic service that is not included in this code. Once the tumor is identified, the nephroscope is exchanged for a resectoscope, which is specifically designed for the resection of tissue. The tumor is then carefully resected and removed, with the use of irrigation and an endoscopic evacuation device to manage the surgical site. After the tumor has been excised, the kidney is re-examined to confirm the complete removal of the tumor, and any bleeding is controlled through a process known as fulguration. Finally, the resectoscope is removed, the nephrostomy tube is replaced, and the external drainage bag is reattached, ensuring that the kidney continues to drain properly post-procedure.