Urology Coding Alert
Query Urologist for Full Procedure Details
Question: My urologist is going to be performing surgery for an adult patient whose insurance requires prior authorization. The doctor wrote “lysis of penile adhesions, takedown of tethering penile frenulum, and indicated procedures” as the procedures he plans to perform. What codes should I submit to the insurance company?
North Carolina Subscriber
Answer: The answer depends on whether your urologist is also performing a circumcision procedure. If he does perform a circumcision procedure, you’ll only report 54161 (Circumcision, surgical excision other than clamp, device, or dorsal slit; older than 28 days of age). That code includes the lysis of adhesions and takedown of the frenulum.
Alternative: If your urologist is not performing a circumcision, you should instead report 54450 (Foreskin manipulation including lysis of preputial adhesions and stretching) for this surgery.
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