Please advise correct coding for the following surgery:
Ureteroscope was inserted per stoma which was tight & very had to open & find the opening into conduit so we tried a wire where there seemed to be some openings, however, the wire would not pass. Used cystoscope & looked again & could not find an opening. Tried a regular Foley catheter, 12-French, which did not enter so used a straight cath 8-French & that was easily able to fine the pathway into the conduit. Then placed a wire through it after we had made an opening at the end & then removed the catheter & left the wire in place. Then went ahead & placed the Ureteroscope over the wire into the loopogram & the loopogram revealed that there were no abnormalities & one of the ureteral orifices was seen & it was wide open. No other abnormalities seen, no lesions seen. Inserted loopogram through it. there were smooth walls, hydronephrosis to the left. Left the wire in place & removed the ureteroscope & again went ahead & placed an 80Frnch & then started dilating with a 10-French, 12-French & 14-French without any difficulty emptying the bladder . The area was nicely dilated & the catheter was passed very easily through it. Placed the conduit device back on the stoma.
Would procedure code 52281 be the appropriate code?
Ureteroscope was inserted per stoma which was tight & very had to open & find the opening into conduit so we tried a wire where there seemed to be some openings, however, the wire would not pass. Used cystoscope & looked again & could not find an opening. Tried a regular Foley catheter, 12-French, which did not enter so used a straight cath 8-French & that was easily able to fine the pathway into the conduit. Then placed a wire through it after we had made an opening at the end & then removed the catheter & left the wire in place. Then went ahead & placed the Ureteroscope over the wire into the loopogram & the loopogram revealed that there were no abnormalities & one of the ureteral orifices was seen & it was wide open. No other abnormalities seen, no lesions seen. Inserted loopogram through it. there were smooth walls, hydronephrosis to the left. Left the wire in place & removed the ureteroscope & again went ahead & placed an 80Frnch & then started dilating with a 10-French, 12-French & 14-French without any difficulty emptying the bladder . The area was nicely dilated & the catheter was passed very easily through it. Placed the conduit device back on the stoma.
Would procedure code 52281 be the appropriate code?
Any suggestions would be greatly appreciated.