Urology Coding Alert

Question: The urologist placed a needle into the corpora and aspirated blood from the patient’s penis, then injected phenylephrine for detumesce of the prolonged erection. A shunt was not involved. Is there a specific CPT^® code for this, or would it be the unlisted code because the urologist didn’t use a shunt to decrease the erection?

Louisiana Subscriber

Answer: You should report this with 54220 (Irrigation of corpora cavernosa for priapism) instead of an unlisted code and 54235 (Injection of corpora cavernosa with pharmacologic agent[s]). Although these two CPT^® codes are not bundled, many carriers will only reimburse for code 54220 and deny code 54235.

Explanation: During this procedure, the physician inserts a large bore needle into the body of the penis (corpora cavernosa) and aspirates blood to relieve the penile pressure. He then irrigates the space with saline solution. He may inject medication into the same region, repeating it several times to get the abnormal erection to resolve.