Urology Coding Alert
Here's the Difference Between 54900 and 55400
Question: The urologist performed a vasovasotomy (vas reversal) with an epididymovasostomy. Is there a CPT® code for this, or do I file with 55400? Delaware Subscriber Answer: There are two procedures available to bypass obstruction in the male genital tract. One is represented by code 54900 (Epididymovasostomy, anastomosis of epididymis to vas deferens; unilateral) and the other by 55400 (Vasovasostomy, vasovasorrhaphy). Vasovasostomy (literally meaning connection of the vas to the vas) is a surgery by which vasectomies are reversed. Another surgery for vasectomy reversal is vasoepididymostomy. If the physician suspects blockage at the level of the epididymis, a vasoepididymostomy (54900) can be performed. Vasoepididymostomy is a technically more demanding procedure than vasovasostomy. If only vasectomy reversal is performed, then 55400 would be the appropriate code for the scenario you describe. If the epididymis is also involved, however, then you may submit 54900 instead, depending on your operative documentation. Although these two CPT® codes are not bundled, clinically speaking it would be very unusual to perform both of these procedures at the same time.
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