Urology Coding Alert

Question: I am currently billing the post-vasectomy semen analysis. How many post operative semen analyses are billable? How safe are we with the wording involved with the 55250 where it states post operative semen examination(s)? Is that just referring to the 90- day global or does that mean all post operative semen analysis?

Answer: The statement in the 55250 (Vasectomy, unilateral or bilateral [separate procedure], including postoperative semen examination[s]) code descriptor "post operative semen examination(s)" should include all semen specimens needed to determine when the patient has become azoospermic or sterile, with no sperm seen on a semen specimen smear. This represents when it becomes safe for the patient to have unprotected intercourse.

Any semen examination after the demonstration of azoospermia would then be a billable service. Including the performance of semen analyses in the vasectomy fee would be unrelated to whether the analyses were performed within or out of the global period.