Ask Dr. Z

How would you code a nephrourteral stent replacement when the stent fell out at home? The tract is already in place, so a new stent would be overcoding, wouldn't it? Please see below.

INDICATION: Nephroureteral stent accidental dislodgment and removal. PROCEDURES: 1. Percutaneous nephroureteral stent placement using fluoroscopic guidance. 2. Nephrostogram. Patient's existing skin defect at previous nephroureteral stent slight was probed with a KMP catheter and Glidewire. Tract was identified and Glidewire and came P. were advanced into the renal pelvis and down into the bladder. Wire was changed for a Amplatz wire. A 10 French nephroureteral stent was placed. This is confirmed by contrast injection which showed moderate hydroureteronephrosis. Catheter was secured to the skin with stitches Catheter was secured to skin with suture. The patient tolerated the procedure without complication.