Ask Dr. Z

Has there been any updated guidance for the below procedure since CPT 50395 was deleted?

Technique:

1. Fluoroscopic guided access of a posterior calix of the left kidney.

2. Antegrade left-sided nephrostogram.

3. Placement of a percutaneous nephrostomy access wire into the bladder.

Using fluoroscopic guidance, a 21-gauge Chiba needle was advanced into a posterior calix within the mid pole. A micro wire was advanced into the collecting system. The needle was exchanged for a triaxial transitional dilator. Injection of contrast confirmed position within the renal collecting system. Oblique views of the caliceal access demonstrated satisfactory positioning. A Benson wire was advanced through the transitional dilator into the bladder.