Urology Coding Alert

Question: The patient underwent a surgical exploration and a detorsion of right testis along with a bilateral orchiopexy. These were descended testicles and the urologist used a scrotal approach. Am I correct that 54600 covers all the service?

North Dakota Subscriber

Answer: Based on your description of the procedure, 54600 (Reduction of torsion of testis, surgical, with or without fixation of contralateral testis) will cover the detorsion and bilateral orchiopexy.

By contrast, CPT^® code 54620 (Fixation of contralateral testis (separate procedure)) applies if the patient returns at a later date to have the contralateral testis pexed, or if it is performed during the same operative session as another procedure (such as an orchiectomy on the other side). Code 54620 can also be used if the orchiopexy is done when the patient is not experiencing symptoms. For example, the patient returns for a trans-scrotal bilateral orchiopexy for recurrent torsion of the testis, but is not currently exhibiting symptoms of torsion. In this instance, reporting the detorsion with 54600 would be incorrect; you should report 54620 with modifier 50 (Bilateral procedure) instead.

If the orchiopexy is for an undescended testicle rather than torsion, you would use 54640.

Also note: Per CCI Edits, you can never bill 54600 in conjunction with 54620.