CPT® Code 50705

Add-On Code

Ureteral embolization or occlusion, including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation (List separately in addition to code for primary procedure)

Ureteral embolization or occlusion is a medical procedure designed to block or interrupt the flow of urine from the kidneys to the bladder. This intervention is particularly indicated in cases where chronic or refractory lower urinary tract fistulas are present. Fistulas can develop due to various underlying conditions, including trauma, malignancy, or radiation exposure, which can compromise the normal urinary tract function. The procedure involves the use of imaging guidance, such as ultrasound and/or fluoroscopy, to ensure precise placement of instruments and to minimize complications. The process typically begins with the establishment of percutaneous access, where a trocar or Chiba needle is inserted below the 12th rib under imaging guidance. This careful approach helps to avoid injury to surrounding structures, such as the pleura. Once access is achieved, the renal pelvis is accessed, and urine is aspirated to confirm the correct location and relieve any pressure in the urinary system. Following this, a thin wire is threaded into the distal ureter, and a delivery catheter or access sheath is introduced to facilitate the insertion of embolic materials, such as stainless steel coils and gelatin sponge pledgets, which are used to occlude the ureter. The procedure is completed with additional imaging to confirm successful ureteral occlusion, and it is important to note that this code is listed separately in addition to the code for the primary procedure performed during the same session.