If a patient presents for a nephrostomy tube exchange but the tube fell out at home, should this be coded as a new placement (50432) or as an exchange (50435)?
If the existing nephrostomy tract is patent and the new nephrostomy tube is easily introduced, exchange code 50435 is recommended. If the existing tract is closed and the physician needs to re-establish tract access to place a new nephrostomy tube, this would be coded as a new placement with code 50432.
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