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Official Description

Convert nephrostomy catheter to nephroureteral catheter, percutaneous via pre-existing nephrostomy tract, with ureteral stricture balloon dilation, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation
Short Descr Cnvrt neph cath w/ dil stric
Coverage Carrier Priced
Pricing Indicator(s) 11 – Physician Fee Schedule - Price established using national RVUs
MPI A – Not applicable, as HCPCS priced under one methodology
ASC Payment Group Code YY – 1/01/2023
Processing Note THESE CODES ARE USED ONLY UNDER THE ASC PAYMENT SYSTEM. REFER TO THE 2023 OPPS/ASC FINAL RULE AND THE DISCUSSION ON THE ASC SPECIAL PAYMENT POLICY FOR OPPS COMPLEXITY-ADJUSTED C-APCs FOR MORE INFORMATION.
BETOS P5E – Ambulatory procedures - other
TOS Code(s) 2 – Surgery
Added Date 1/1/2023
APC Status Indicator Non-Covered Service, not paid under OPPS
MUE 1
MUE Not applicable/unspecified.
OTS Orthotic No
Date
Action
Notes
2025-01-01 Note Clerical change.
2023-01-01 Added Code added.
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