Urology Coding Alert

Question: My surgeon performed an orchiopexy via a scrotal approach instead of using an inguinal or abdominal approach. What CPT® code should I use?

Michigan Subscriber

Answer: There is no specific CPT^® code for a trans-scrotal orchiopexy, fixation of a testicle in the scrotum via a scrotal incision. There are codes for an inguinal approach (54640, Orchiopexy, inguinal approach, with or without hernia repair) and an abdominal approach (54650, Orchiopexy, abdominal approach, for intra-abdominal testis [e.g., Fowler-Stephens]), but nothing specific to a scrotal approach.

Best option: Rather than submit an unlisted procedure code, bill with 54620 (Fixation of contralateral testicle). This procedure is a trans-scrotal procedure used for an undescended testicle, a retractile testicle, or a testicle torsion. Therefore, the most appropriate CPT® code for this approach is 54620. Also note that you may add modifier 50 (Bilateral procedure) if the procedure is performed bilaterally.