Ask Dr. Z

I have questions pertaining to 50395 and the codes replacing it in 2019. Our patients are brought to the IR suite and the radiologist places new access (usually a long 6 French sheath) into the distal ureter or bladder prior to going to the OR for PCNL. In the past we have not used 50395 since the description specifically states “with dilation”, which we aren’t doing. We were instructed to use 50433 since we aren’t dilating the tract to 24 French. In some of your responses I see that you’re separating 50395 as the intro and 74485 as the dilation. Should we be using 50395 for this access, and is there a radiology S&I code to use with it? Also, what do you suggest for 2019? Are 50436 and 50437 meant to be used by radiology in the scenario I described? Both new CPT descriptions seem to focus on dilation of an existing tract. We’re looking for some help understanding these new codes.