Wiki Excision of scrotal sinus tract

[KaylaRieken]

Any suggestions on what CPT & ICD 10 codes to use??

We identified the scrotal sinus tract in the left inferior aspect of the scrotum towards the perineum. We advanced a prob within the tract to help delineate the length of the tract. The tract did extend fairy deep towards the perineum at least 5 cm deep. The skin was incised started marked out around the sinus tract and incised with a scalpel. The dissection was further deepened circumferential around the sinus tracing and deep into the perineum, we did place a urethral catheter to help delineate the urethral anatomy to avoid injury. The sinus tract did trace down towards the bulbar aspect of the urethra. I was able to avoid any injury in the urethra by dissecting close to the sinus tract. The tract was transected; however, it was clear that after transection tract was tubular in nature and was further extending into the perineum. A babcock was used to grasp the segment of the tract and that was further dissected from surrounding attachments using the Metzenbaum scissors. At this point, we were able to get to the base of the tract, and this was excised from surrounding tissues. The sinus tract was then sent for pathologic analysis. Hemostasis was achieved, and the area was irrigated. The skin was close in layers with 2 layers of 3-0 Vicryl, followed by Monocryl and Dermabond.

Would 13160 or 11470 be correct? N49.2?

 

[daniel]

55899
'Unlisted' Is Your Only Choice for Scrotal Fistula Excision
Published on Tue May 15, 2018

PDF



Question: The urologist completed an excision of a scrotal fistula, scrotal exploration, and cystourethroscopy. I know the codes for the exploration and cystoscopy, but don't know what to choose for the scrotal fistula excision. What should I do?

West Virginia Subscriber

Answer: CPT® does not currently include a code specifically for excision of a scrotal fistula. Because of that, you should file with 55899 (Unlisted procedure, male genital system). Include a cover letter stating why you are reporting the "unlisted procedure" code with a clear explanation of exactly what the urologist did.

Also report 55110 (Scrotal exploration) for the exploration and 52000 (Cystourethroscopy [separate procedure]) for the cystoscopy. Coding edits do not prevent you from reporting all three codes together. However, remember, many payers may consider the scrotal exploration part of your unlisted procedure depending on your operative report which they will review and then likely not reimburse for code 55110. Reimbursement for the cystoscopic examination will depend on the reason or diagnosis for the endoscopy.