Urology Coding Alert

Question: My urologist saw a patient with testicular torsion. He was able to manipulate the testicles by hand to correct the problem. What is the right code for this procedure?

New Hampshire Subscriber

Answer: You should not report a procedure code for your urologist’s manipulation of the testes. This is not an operative procedure per se but an external manipulation of the scrotum and a counter twisting of the spermatic cord within or outside of the tunica vaginalis (sac) to reduce the torsion of the cord and testicle itself. 

Therefore, you should include this work in the evaluation and management code you report for the office encounter. For example, if the patient is established and your urologist documents a level four E/M service, you’ll report 99214 (Office or other outpatient visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: a detailed history; a detailed examination; and medical decision making of moderate complexity …) alone. 

Diagnosis help: The most likely diagnosis code for this encounter will be 608.20 (Torsion of testis, unspecified). Once you start using ICD-10 codes, you will report N44.00 (Torsion of testis, unspecified).