Urology Coding Alert
Submit 64722 or 55899, Depending on Payer
Question: The surgeon performed bilateral inguinal incisions and divided the cremasteric muscles from both spermatic cords. I don’t think the scrotal exploration code will provide what I need, so I’m looking at unlisted procedure codes. Is there a code that I can add modifier 52 to that will come close?
Georgia Subscriber
Answer: For a Medicare carrier, your best option is to report the division of the cremasteric muscle with the closest code (such as 64722, Decompression; unspecified nerve[s] [specify]) and append modifier 52 (Reduced services). Be sure the surgeon documents which nerve was treated. For a non-Medicare payer, submit 55899 (Unlisted procedure, male genital system) and benchmark it to 64722 and provide a detailed operative report and cover letter.
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