Primary Care Coding Alert

Question: I am coding the excision of a hydrocele of the spermatic cord. I understand that the correct procedure codes would be 55500 (excision of hydrocele of spermatic cord, unilateral [separate procedure]), but would like more information on what diagnosis code to assign. I was told that there is only one diagnosis code to assign for either a hydrocele or a varicocele. This doesnt make sense to me because there are specific CPT codes for each of these procedures.

Jennifer LaJoste
Morgan City, La.

Answer: You are correct. There are different ICD-9 codes to assign for hydroceles and varicoceles. The diagnosis for excision of hydrocele is in the 603.x section of the ICD-9 manual (e.g., 603.1, infected hydrocele).

Excision of a scrotal varicocele is an entirely different condition and would be reported with 456.4 (scrotal varices). The corresponding procedure code would be 55530 (excision of varicocele or ligation of spermatic veins for varicocele; [separate procedure]), 55535 ( abdominal approach) or 55540 ( with hernia repair).


You Be the Coder and Reader Questions were reviewed by Daniel S. Fick, MD, director of risk management and compliance for the College of Medicine faculty practice at the University of Iowa in Iowa City, Iowa; Kent Moore, manager of Health Care Financing and Delivery Systems for the American Academy of Family Physicians based in Kansas City, Mo.; and Susan Callaway, CPC, CCS-P, an independent coding consultant and educator in North Augusta, S.C.