CSHCN Services Program 2010 > Physician > Benefits, Limitations, and Authorization Requirements

    
 

30.2.19 Extracorporeal Shock Wave Lithotripsy (ESWL)

Procedure code 50590 is a benefit for the following diagnosis codes:

Diagnosis Code
Description

591

Hydronephrosis

5920

Calculus of kidney

5921

Calculus of ureter

5929

Unspecified urinary calculus

All claims received for ESWL must include one of these diagnoses.

Texas Medicaid & Healthcare Partnership
CPT only copyright 2009 American Medical Association. All rights reserved.
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