Urology Coding Alert

Ques.: My urologist did a vasectomy and removed eight scrotal sebaceous cysts at the same time. Which CPT Codes & ICD-9 Codes should I use?

California Subscriber

Answer: You should code the excision of each sebaceous cyst according to the size of each cyst removed. Choose codes from the 11420-11426 (Excision, benign lesion including margins, except skin tag [unless listed elsewhere], scalp, neck, hands, feet, genitalia ...) range based on the excised diameter including margins. Your diagnosis for sebaceous cyst would be 706.2 (Sebaceous cyst).

Don't miss: You will need a secondary diagnosis to explain the medical reason(s) for the cyst removal if you expect a payer to reimburse you for this service, however. Some possible ICD-9 codes that could apply are 459.0 (Bleeding), 686.8 (Other specified local infections of skin and subcutaneous tissue), 695.9 (Other specified erythematous conditions; other), or 782.0 (Disturbance of skin sensation). Without one of these secondary diagnoses, many payers, including Medicare, may not reimburse for the cyst excisions. Go back to your urologist's documentation to find the diagnosis that supports the medical necessity for the excisions.

For the primary procedure you should report code 55250 (Vasectomy unilateral or bilateral ...) with V25.2 (Sterilization).