Retrograde Pyelogram (RPG)

Created Oct 2014
Reviewed Dec 2019

Query

Can [1066] Endoscopic ureteric catheterisation RPG codes be assigned with codes that already include ureteroscopy?

Response

RPG is classified as an imaging procedure in ACHI Chapter 20 therefore will not be coded as per ACS 0042 Procedures normally not coded (see bullet point 11 Imaging services),

In ACHI there are numerous index entries where retrograde pyelography is listed as a sub-entry therefore coders should follow the ACHI Index when determining correct code assignment for example, in the case where ureteric catheterisation, cystoscopy and RPG are performed a code from block [1066] would be assigned following the ACHI index below “with fluoroscopic imaging”.

Catheterisation

- ureter (closed) (endoscopic) (unilateral) 36824-00 [1066]
- - with fluoroscopic imaging of upper urinary tract 36818-00 [1066]
- - bilateral 36824-01 [1066]
- - - with fluoroscopic imaging of upper urinary tract 36818-01 [1066]

In the case of insertion of ureteric stent, cystoscopy and RPG the code 36821-01[1067] would be assigned following the ACHI Index below.

Insertion

- stent

- - ureter (closed) (endoscopic) (JJ stent) 36821-01 [1067]

In the above index entry there is no sub-entry for ‘with fluoroscopic imaging’, therefore free text should be used to specify the RPG.

RPG should not be coded separately as per ACS 0042 bullet point 11 Imaging services or by assigning an additional code from block [1066].

Back to top