New CPT code descriptor: CPT 54640 - Orchiopexy, inguinal or scrotal approach (For bilateral procedure, report 54640 with modifier 50) (For inguinal hernia repair performed in conjunction with inguinal orchiopexy, see 49495-49525)
| 2019 | 2020 |
|---|---|
| 54640 Orchiopexy, inguinal approach, with or without hernia repair | ▲54640 Orchiopexy, inguinal or scrotal approach |
What is the CPT code for surgery 54640?
CPT ® 54640, Under Repair Procedures on the Testis The Current Procedural Terminology (CPT ®) code 54640 as maintained by American Medical Association, is a medical procedural code under the range - Repair Procedures on the Testis. Subscribe to Codify and get the code details in a flash. Request a Demo 14 Day Free Trial Buy Now
What is the CPT code for orchiopexy?
54650 – Orchiopexy, abdominal approach, for intra-abdominal testis (e.g., Fowler-Stephens). Take note: Code 54640 when the urologist performs an orchiopexy, regardless of whether he or she also performs – or does not perform – a hernia repair.
What is the CPT code for orchiopexy with testicular torsion?
Alternative: For an orchiopexy for a testicular torsion, you should instead use code 54600 ( Reduction of torsion of testis, surgical, with or without fixation of contralateral testis) or 54620 ( Fixation of contralateral testis [separate procedure] ). Loading....
When to report a hernia repair code in addition to orchiopexy?
If documentation indicates that significant additional work to repair the hernia is required for the patient, as NCCI rules allow reporting of the hernia repair code in addition to the orchiopexy, we recommend reporting both codes instead of using modifier –22 on the orchiopexy code.
What is procedure code 54640?
CPT® 54640, Under Repair Procedures on the Testis The Current Procedural Terminology (CPT®) code 54640 as maintained by American Medical Association, is a medical procedural code under the range - Repair Procedures on the Testis.
What is the CPT code for Orchiopexy?
CPT code 54640 (Orchiopexy, inguinal approach, with or without hernia repair) clearly states that hernia repair is included.
What is the CPT code for laparoscopic Orchiopexy?
54692In this situation you should report 54692 (Laparoscopy, surgical; orchiopexy for intraabdominal testis).
What does the term Orchiopexy mean?
Orchiopexy (or orchidopexy) is a surgery to move an undescended (cryptorchid) testicle into the scrotum and permanently fix it there. Orchiopexy typically also describes the surgery used to resolve testicular torsion. Urology 216.444.5600.
Is orchiopexy a major surgery?
An orchiopexy is an outpatient procedure that takes place in the hospital and requires general anesthesia. Pediatric urologic surgeons at NYU Langone are experienced in performing this surgery in boys as young as 6 months old. During the procedure, the surgeon makes a small incision in the groin or scrotum.
What is the CPT code for orchiectomy?
If you see in the documentation that the urologist performed the orchiectomy laparoscopically, you should report CPT® code 54690 (Laparoscopy, surgical; orchiectomy).
What is the CPT code for testicular torsion repair?
Alternative: For an orchiopexy for a testicular torsion, you should instead use code 54600 (Reduction of torsion of testis, surgical, with or without fixation of contralateral testis) or 54620 (Fixation of contralateral testis [separate procedure]).
What is the ICD 10 code for undescended testicle?
ICD-10 code Q53. 2 for Undescended testicle, bilateral is a medical classification as listed by WHO under the range - Congenital malformations, deformations and chromosomal abnormalities .
What is the CPT code for circumcision?
CPT® Code 54161 in section: Circumcision, surgical excision other than clamp, device, or dorsal slit.
When do you use orchiopexy?
The highest quality evidence recommends orchiopexy between 6 and 12 months of age. Surgery during this timeframe may optimize fertility potential and protect against testicular malignancy in children with cryptorchidism.
Why is an orchiopexy done?
Surgical correction (Orchidopexy) Orchidopexy is a surgical procedure that moves an undescended testicle into the scrotum. The operation is performed to reduce the risk of crush injury, correct the associated hernia, and/or alleviate the psychological concerns of having only one testicle visible in the scrotum.
What is orchiopexy for testicular torsion?
Orchiopexy (say "OR-kee-oh-peck-see") is a type of surgery. It fixes a problem called testicle torsion. This happens when a testicle twists and the cord that supplies blood to your testicle also twists. Then blood can no longer flow to the testicle.
What are the new CPT codes for urology?
There are several Current Procedural Terminology (CPT®) code changes that urologists should understand that will be effective January 1, 2020, including changes to the orchiopexy code, new codes for biofeedback (with elimination of the old code), a new Category III code Transurethral ablation of malignant prostate tissue by high-energy water vapor thermotherapy with a new parenthetical to CPT 53854, and four new Category III codes for Percutaneous implantation or replacement of integrated single device neurostimulation system including electrode array and receiver or pulse generator.
What is CPT code 0582T?
Background: A new Category III code 0582T has been established for reporting transurethral ablation of malignant prostate tissue by high-energy water vapor thermotherapy, including intraoperative imaging and needle guidance. Parenthetical notes have been added to provide guidance on the appropriate reporting of code 0582T. Currently, code 53854 is used to report the indirect application of radiofrequency (RF) energy in the form of water vapor thermotherapy to ablate prostate tissue. New code 0582T is used to report transurethral ablation of malignant prostate tissue by high-energy water vapor thermotherapy, including intraoperative imaging and needle guidance. Exclusionary parenthetical notes were added restricting the use of code 0582T with other codes in the CPT code set.
What is 54640 in coding?
The following change in description will become effective Jan. 1, 2020: 54640 (Orchiopexy, inguinal approach, with or without hernia repair) will change to 54640 (Orchiopexy, inguinal or scrotal approach). This description change was made to reflect the current National Correct Coding Initiative coding data set that will allow reporting of hernia repair with orchiopexy, as well as adding scrotal approach.
What is the code for Rezum procedure?
Note that the Rezum procedure for BPH is still reported with code 53854. The new category III code 0582T is for treatment of malignant prostate tissue.
What is the CPT code for a nephrostomy tube?
According to an AUA “Coding Corner” article, however, placement of a nephrostomy tube by the urologist can be separately reported with CPT code 50432 with code 50080 or 50081 when performed ( bit.ly/auacodingcorner ).
What is CPT code 50080?
Continue to the next page for more. The 2019 CPT manual also included the following note under codes 50080 (Percutane ous nephrostolithotomy or pyelostolithotomy, with or without dilation, endoscopy, lithotripsy, stenting, or basket extraction; up to 2 cm) and 50081 (Percutaneous nephrostolithotomy or pyelostolithotomy, with or without dilation, endoscopy, lithotripsy, stenting, or basket extraction; over 2 cm).
What is the ICD-10 code for urine?
Using the new codes as an example, before the update on Oct. 1, 2019, code R82.8 (Abnormal findings on cytological and histological examination of urine) was a valid ICD-10 code that may have been tied to either a specific shortcut list for a provider or to a specific HPI macro to prepopulate the charge communication form. As of Oct. 1, 2019, the same diagnosis now requires the addition of an additional digit R82.89 (Other abnormal findings on cytological and histological examination of urine).
What is the code for perineal muscles?
Code 90911 (Biofeedback training, perineal muscles, anorectal or urethral sphincter, including EMG and/or manometry) was deleted and replaced with the following codes: 90912 (Biofeedback training, perineal muscles, anorectal or urethral sphincter, including EMG and/or manometry, when performed; initial 15 minutes of one-on-one physician or other qualified health care professional contact with the patient) and 90913 (each additional 15 minutes of one-on-one physician or other qualified health care professional contact with the patient). Parenthetical instructions have also been added.
How many new ICD-10 codes are there for 2020?
Over the past few years, this has resulted in a few major changes and a few changes that seemed minor but resulted in major payment delays. For 2020, the code set saw 273 new codes and 21 deleted codes. There were a number of changes to ICD-10 notes throughout the nomenclature but no major changes to the guidelines.
What is the CPT code for pelvic packing?
For CPT 2020, a new CPT Category I code (49013) was approved to report preperitoneal pelvic packing without a laparotomy. A second code (49014) was approved for packing removal that will occur on a subsequent day. These two new codes differ from other exploratory procedures in that a laparotomy is not performed. Instead, a Pfannenstiel low horizontal incision is made just above the pubic rim, with dissection carried out until the urinary bladder is identified, without opening the peritoneum. Table 4 provides the new code descriptors and RVUs for 2020.
When will the 19304 code be removed?
A subcutaneous mastectomy (that is, removing some breast tissue) is a technique introduced in the 1960s that is no longer standard of care; therefore, code 19304 will be deleted for 2020.
What is the deletion of the incision and excision subheadings?
The “Incision” and “Excision” subheadings will be deleted from the CPT Integumentary System, Breast subsection. The guidelines preceding the breast biopsy codes (previously under the deleted “Excision” subheading) have been extensively revised, including the addition of clear instructions for reporting percutaneous and image-guided breast biopsy, open incisional breast biopsy, and open excision of a breast lesion. Similarly, the guidelines under the “Breast, Introduction” subheading have been extensively revised to provide clear instructions for reporting percutaneous image-guided placement of breast localization device (s). Instructions also have been added for correct reporting of bilateral procedures, and new introductory text has been added to the Breast, Mastectomy Procedures subsection that describes and differentiates mastectomy procedures.
What is CPT code 0249T?
CPT Category III code 0249T, Ligation, hemorrhoidal vascular bundle (s), including ultrasound guidance, has been deleted and converted to CPT Category I code 46948, Hemorrhoidectomy, internal, by transanal hemorrhoidal dearterialization, 2 or more hemorrhoid columns/groups, including ultrasound guidance, with mucopexy, when performed. THD is a nonexcisional surgical technique developed for the treatment of internal hemorrhoids. This technique is based on the identification and ligation of the terminal branches of the superior rectal artery through a specially developed anoscope equipped with an ultrasound probe that allows localization of arteries that are individually ligated as needed to interrupt hemorrhoid blood supply. When required, a ring of sutures also will be deployed to pull up a prolapse (mucopexy). Family codes 46945 and 46946 were revised to differentiate the work from new code 46948. Separately, all parenthetical references to deleted code 0249T also will be revised. New code 46948 indicates that at least two columns/groups must be treated to report this code. If only one column/group is treated, then code 46999, Unlisted procedure, anus, should be reported. Table 3 provides the new and revised code descriptors and RVUs for 2020.
What is complex repair in CPT?
The introductory guidelines in the CPT Integumentary System, Repair (Closure) subsection have been revised to provide more descriptive language to clarify that intermediate repair includes limited undermining. The guidelines also clarify that complex repair includes all the requirements listed for intermediate repair plus at least one of the following: exposure of bone, cartilage, tendon, or named neurovascular structure; debridement of wound edges; extensive undermining; involvement of free margins of the helical rim, vermillion border, or nostril rim; or placement of retention sutures. References to stents and scar revision have been removed from the complex repair guidelines. The guidelines also will include a definition and an illustration (see Figure 1) of extensive undermining. Please refer to the CPT code book for detailed definitions of intermediate and complex repair.
What are the codes for artery exploration?
One code (35701) has been revised, two new codes (35702, 35703) have been added, and three codes (35721, 35741, 35761) have been deleted. Prior to CPT 2020, the code descriptors for exploration of artery included the language “with or without lysis of artery.” Since lysis of the artery during exploration rarely is performed, this language has been removed from the code descriptors. The revised code and new codes continue to indicate that an artery is explored and “not followed by surgical repair.” Existing code 35701 has been revised to describe exploration of artery in the neck. New code 35702 was established to report exploration of an upper extremity artery and new code 35703 was established to report exploration of a lower extremity artery. The code descriptors include examples of typical arteries. Codes 35721 (exploration of femoral artery) and 35741 (exploration of popliteal artery) were deleted with directions to report exploration of a lower extremity artery with code 35703. Code 35761 (exploration of other artery) was deleted with directions to use 37799 to report vascular exploration not followed by surgical repair, other than neck artery, upper extremity artery, lower extremity artery, chest, abdomen, or retroperitoneal area.
What is the code 99421?
Codes 99421–99423 are reported once for the physician’s or other qualified health care professional’s cumulative time devoted to the digital E/M service during a seven-day period. This codeset includes significant restrictions and instructions for correct reporting. The patient must be an established patient, although the problem may be new. The patient must initiate the eVisit, and communication platforms must comply with HIPAA. These codes may not be reported if a separately reported E/M visit occurs within seven days of the first day of patient inquiry. Refer to the CPT code book for detailed guidelines and coding instructions. Table 7 provides the new code descriptors and RVUs for 2020.
Is CPT black and white?
Excellent question, because the answer is not black-and-white. The rules are somewhat confusing in many areas and often inconsistent. Typically, CPT is the foundation for coding and reimbursement and rules for payment take into account CPT descriptions and included services.
Can you use two NCCI codes on the same date?
However, payer rules (in this case NCCI edits that can be viewed in AUACodingToday) show that the two codes, if billed for the same date of service, would be allowed. Payer rules usually trump CPT rules. There are many examples that state that you should follow payer rules if there is a conflict between CPT and the payer.
Can you code a hernia repair?
As CPT and payer rules are in conflict for this situation, we have implemented a general rule for coding these cases: Respecting what we believe is the intention of the CPT description, if the hernia repair is incidental, we will recommend not coding for the hernia repair. If documentation indicates that significant additional work to repair the hernia is required for the patient, as NCCI rules allow reporting of the hernia repair code in addition to the orchiopexy, we recommend reporting both codes instead of using modifier –22 on the orchiopexy code.
