Urology Coding Alert

Question: Should we be reimbursed for a bilateral reduction of torsion of testes? I billed this procedure code CPT 54600 with modifier -50, 2 units. United Health Care states that the number of units is incorrect and exceeds the typical frequency per day for the procedure. They only paid for one unit. How should I handle this? 

Texas Subscriber

Answer: Private or commercial carriers that accept one-line coding with modifier -50 (Bilateral procedure) for bilateral procedures will only accept the reduction procedure if it's reported as a one-unit procedure. Most private or commercial carriers, however, only recognize a two-line coding for bilateral procedures.

For most commercial carriers, you should report the following: 54600 (Reduction of torsion of testis, surgical, with or without fixation of contralateral testis) -LT (Left side) one unit, 54600-RT (Right side) -50 one unit. Medicare will accept this coding instead: 54600-50 one unit.