Urology Coding Alert

Question: What is the difference between a simple orchiectomy and partial orchiectomy? I don't know when to use 54520 versus 54522.

Texas Subscriber

Answer: Simple orchiectomy involves the removal of one or both testicles at the distal spermatic cord, usually through an anterior trans-scrotal approach. You would code this procedure using 54520 (Orchiectomy, simple [including subcapsular], with or without testicular prosthesis, scrotal or inguinal approach).

A partial orchiectomy preserves the testicle in a patient who has a tumor that can be removed without removing the organ. A partial orchiectomy is technically more sophisticated than a radical orchiectomy. For a partial orchiectomy you'll report 54522 (Orchiectomy, partial).

Pitfall: Don't be tempted to report a partial orchiectomy by using 54520 with modifier 52 (Reduced service) appended. Before CPT introduced 54522 in 2001 that was your only coding option for a partial orchiectomy, but now you should use 54522.