Ask Dr. Z

Would the following be reported with code 50387, or should we report codes 50389 and 53899?

"Patient is status post cystectomy and ileal conduit and had antegrade NUC catheter placed a month ago. They now present for conversion of this to a retrograde trans-stomal NUC. Patient was placed in right lateral decubitus position with the left side up. A scout image was obtained, and contrast was injected through the existing catheter showing adequate position of the LEFT NUC pigtails in the renal pelvis and conduit. The catheter was cut to release the pigtail. Glidewire was inserted through the existing nephroureteral catheter and positioned in the bladder under fluoroscopic guidance. The tube was then removed over the wire, and a sheath was placed. A LEFT antegrade nephrostogram was performed. The Glidewire was then advanced out of the stoma in his right lower quadrant. A new nephroureteral catheter was advanced over the wire retrograde via the stoma under fluoroscopic guidance. The pigtail was coiled in the renal pelvis, and the proximal hub exited the stoma into the ostomy bag."