Advanced Search

Urology Coding Alert

Reader Question:

Use Insertion Code for Prosthesis Revision

Published on Fri May 07, 2004

Question: Our doctor did a revision of a testicular prosthesis with scrotal exploration. The diagnosis was "right testicular prosthesis migration." I can't figure out the correct CPT code.

Alaska Subscriber Answer: The best code would be 54660-52 (Insertion of testicular prosthesis [separate procedure]; Reduced services). This CPT code modified by -52 will indicate a reduced service and not the full implantation of the testicular prosthesis. The exploration of the scrotum is an integral portion of this procedure, and most carriers will consider the fee for the exploration included in the fee for the prosthesis insertion -- so do not bill separately for the exploration.
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in your eNewsletter
  • 6 annual AAPC-approved CEUs*
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more
*CEUs available with select eNewsletters.

Other Articles in this issue of

Urology Coding Alert

View All