Wiki Hypospadias repair question

[ssmith612]

I am hoping for some help with a pediatric urology question. So the patient is having a repair for correction of previous hypospadias repair(54324). During the procedure the md injects the corpora cavernosa with saline for artificial erection to check for penile angulation. Is this able to be billed separately(54235)? There are no code edits for it but my understanding is that 54235 is used for pharmacologic agents injected for treatment of ED. I cant' find anything concrete supporting one or the other.
Thanks

 

[emcee101]

Just my two cents, but if I were coding this op note I wouldn't code the 54235 for two reasons.

1.) As you mentioned, 54235 is used to inject pharma agents (i.e. Tri-Mix, Bi-Mix, etc.) to treat ED for patients ho do note respond to oral therapy Your doc did not use any pharma agents, even though the work he did was the same if not identical to the work performed in a pharma injection.

2.) I have always gone by the rule that if a physician performs a minor procedure that is necessary in order for them to complete a more involved or complex procedure, that it should not be separately coded, except in a few specific instances.

I'm interested to hear others thoughts on this, as I'm sure opinions vary from coder to coder.

Regards!