You Be the Coder:
Reduction of Paraphimosis
Published on Fri Nov 01, 2002
Test your coding knowledge. Determine how you would code this situation before looking at the box below for the answer.
Question: How should I code for reduction of paraphimosis for an uncircumcised male who requires local anesthesia and compression for the draining of the edema?
New Jersey Subscriber
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Answer: Paraphimosis, a condition that occurs in uncircumcised men and boys in which the foreskin of the penis gets stuck behind the head of the penis and can't be pulled back down, can sometimes result in a complicated procedure involving anesthesia, compression and drainage for its correction.
Unfortunately, only one code can be used for paraphimosis: 54450 (Foreskin manipulation including lysis of preputial adhesions and stretching).
When a local anesthetic has to be administered to complete the procedure, it is included in the global surgical package of 54450 and is therefore not separately billable.
For an unusually complicated paraphimosis procedure, you may be able to append modifier -22 (Unusual procedural services) to the procedure code, but be sure to include very thorough documentation of the elements of the procedure that warrant the use of this modifier. | |
