Reviewed on May 27, 2015; no changes to content
Question: Our urologist performed a takedown of penile adhesions plus urethral dilation and meatotomy with meatoplasty on an adult. How should I code this?
Utah Subscriber
Answer: Report code 53450 (Urethromeatoplasty, with mucosal advancement) for both the meatotomy and the meatoplasty. Don't report the meatotomy code 53020 (Meatotomy, cutting of meatus [separate procedure]; except infant), since it is bundled into 53450 and can under no circumstances be unbundled, according to National Correct Coding Initiative guidelines.
For the lysis of penile adhesions, report code 54162 (Lysis or excision of penile post-circumcision adhesions), and report 53600 (Dilation of urethral stricture by passage of sound or urethral dilator, male; initial) for the urethral dilation.