Pediatric Coding Alert

Question: Our pediatricians often perform lysis of penile adhesions post circumcision in the office. Can we report the lysis with 54162? Utah Subscriber Answer: Check if the lysis involves instrumentation and general anesthesia. No: If the physician can easily manually break down the postcircumcision adhesions (usually filmy lesions) without using an instrument to cut the adhesions, consider the work part of the office visit (99201-99215). Yes: For lysis of postcircumcision adhesions performed with an instrument under sterile conditions, use 54162 (Lysis or excision of penile postcircumcision adhesions) linked to 605 (Redundant prepuce and phimosis). The procedure requires pain relief, such as a local anesthetic block, as well as general anesthesia to surgically release the skin bridge that has formed on the circumcision incision line. Because tissues bleed more freely at older ages and the physician must manage postoperative pain, the lysis requires more skill than the earlier postcircumcision service. An [...]