Urology Coding Alert

Question: My urologist is performing percutaneous epididymal and/or testicular sperm aspiration for fertility testing. What code can I use for this procedure?

Washington Subscriber

Answer: There are no specific codes for these procedures. Therefore, you should use the unlisted code: 55899 (Unlisted procedure, male genital system). You'll need to send the payer the operative report with a full explanation of the procedures performed and a cover letter explaining the reasons for these procedures.

Coding for these procedures and receiving payments have always been a problem with many payers not reimbursing for them. Before doing one of these procedures, your urologist should have the patient sign a waiver to indicate financial responsibility when and if a payer denies payment.