CPT^® 54405, Under Repair Procedures on the Penis

The Current Procedural Terminology (CPT^®) code 54405 as maintained by American Medical Association, is a medical procedural code under the range - Repair Procedures on the Penis.

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Summary

The provider inserts inflatable synthetic material for a multicomponent, inflatable penile prosthesis into the penis of the patient. The provider also places a pump, the cylinders, and a reservoir into the penis during this procedure.

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Penile prosthesis

Our doctor performs 54405 and 54360 together. On a rare occasion, we receive a denial based on MARS, Medical Audit & Review Solutions, which their source is National Institute for Health and Care Exce... [ Read More ]

Penile prosthesis

I don't see any edits between the 2. My doctors perform 54405 all the time but do not perform a Nesbit with it, so if they did perform the Nesbit I suppose I would code that as well.... [ Read More ]

Penile prosthesis

Does anyone know the correct codes for a penile prosthesis surgery when a Nesbit procedure is also performed? Can you code 54360 with the 54405 code or is this procedure considered included in the imp... [ Read More ]

private-owned, physician-owned, hospital-owned ASC & hospital-based outpatient facility: is there a list of items CMS bundles into CPT codes?

[QUOTE="drronline, post: 463601, member: 629993"] How are these items treated (modifier or paid separately) under Medicare: Scenario 1) ASC - facility bills for 54360 @$12K and 54405@$12K (no modifier... [ Read More ]

private-owned, physician-owned, hospital-owned ASC & hospital-based outpatient facility: is there a list of items CMS bundles into CPT codes?

How are these items treated (modifier or paid separately) under Medicare: Scenario 1) ASC - facility bills for 54360 @$12K and 54405@$12K (no modifier), also sterile supply @$3k, anesthesia @$2k, Reco... [ Read More ]

Penile Prosthesis with Ventral Phalloplasty coding question...

I'm not finding anything current on phalloplasty, and one of my docs does a lot of prosthesis inserts and I have yet to see him dictate an actual phalloplasty. A lot of articles say to use the unliste... [ Read More ]

Penile Prosthesis with Ventral Phalloplasty coding question...

We have a physician that is doing an Insertion of Inflatable Penile Prosthesis (54405) with a Ventral Phalloplasty and Scrotoplasty. Is anyone familiar with billing these together? I know the CPT code... [ Read More ]

Penile Prosthesis with Ventral Phalloplasty coding questions...

Penile Prosthesis with Ventral Phalloplasty coding question...

Remove one type of IPP to replace with different type?

I have a case I have not seen before, but I'm SURE it's not the first time in history this has happened. Patient has had 3 previous two-piece inflatable penile implants, each one has had a malfunction... [ Read More ]

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