# Object on Penis



## Jackie (Aug 31, 2011)

My doctor saw a patient at the ER with a ball bearing around his penis and the doctor had to cut both of the metal circular parts off with a drummel tool.  I can find foreign objects in the penis but not one for cutting an object from around it.  This took over an hour to do this.  Any suggestions???


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## btadlock1 (Aug 31, 2011)

Jackie said:


> My doctor saw a patient at the ER with a ball bearing around his penis and the doctor had to cut both of the metal circular parts off with a drummel tool.  I can find foreign objects in the penis but not one for cutting an object from around it.  This took over an hour to do this.  Any suggestions???



I don't want to know how it got there...

I'd suggest billing a prolonged service code with your ER visit, or adding a 22 modifier. I doubt there's a procedure code to cover that.


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## Mojo (Aug 31, 2011)

If the patient was registered as an ED patient and you are using the ED E/M codes, the 99281-99285 services do not have estimated times associated with them to utliize prolonged services codes. Modifier 22 cannot be appended to E/M services.

Unless an incision was made, the removal is captured in the E/M. This would be similar to a ring on a finger entrapment, albeit the penis is a much more vascular organ and the embarrassment factor was probably tenfold.


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## btadlock1 (Sep 1, 2011)

Mojo said:


> If the patient was registered as an ED patient and you are using the ED E/M codes, the 99281-99285 services do not have estimated times associated with them to utliize prolonged services codes. Modifier 22 cannot be appended to E/M services.
> 
> Unless an incision was made, the removal is captured in the E/M. This would be similar to a ring on a finger entrapment, albeit the penis is a much more vascular organ and the embarrassment factor was probably tenfold.



Do you think it would be considered a significant threat to physiologic function? Might be able to pull off a higher level E/M if the rest of the documentation meets the requirements. It really seems like they should be able to capture the complexity of the work somehow. 

I can only imagine how embarassing that must have been - for everyone involved. I wonder how long the guy dealt with it before he finally decided to go to the ER...


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## Mojo (Sep 2, 2011)

btadlock1 said:


> Do you think it would be considered a significant threat to physiologic function? Might be able to pull off a higher level E/M if the rest of the documentation meets the requirements. It really seems like they should be able to capture the complexity of the work somehow.
> 
> I can only imagine how embarassing that must have been - for everyone involved. I wonder how long the guy dealt with it before he finally decided to go to the ER...



I was thinking the same thing when I was looking at the Table of Risk. If you asked a man, he'd say, "H E L L , YES! Assign critical care!"  If using the ED codes and further w/u like Doppler studies or uroflowmetry are ordered, a high E/M could be assigned if the documentation is there. I read that penile incarceration has been reported since 1755. Some of the case reports note 5-17 hours of incarceration. Dremel tool and penis should not be used in the same sentence.


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## btadlock1 (Sep 2, 2011)

Mojo said:


> I was thinking the same thing when I was looking at the Table of Risk. If you asked a man, he'd say, "H E L L , YES! Assign critical care!"  If using the ED codes and further w/u like Doppler studies or uroflowmetry are ordered, a high E/M could be assigned if the documentation is there. I read that penile incarceration has been reported since 1755. Some of the case reports note 5-17 hours of incarceration. Dremmel tool and penis should not be used in the same sentence.



LMAO! Funniest crap I've read all day...


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## twizzle (Sep 4, 2011)

*Object on penis*

As a guy I find this thread a load of c-ck


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## Kelly_Mayumi (Sep 13, 2011)

Jackie, I just had a similar incident.  My surgeon did have to do an incision and slight debridement.  I used an unlisted male CPT and compared to 10121.


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