Urology Coding Alert

When a patient goes to a urologist complaining of testicular pain, several different therapies can be tried, including anti-inflammatory medication. If this doesnt work, however, one solution is to perform a spermatic cord block. Its important to bill properly for this procedure because you may have to do the procedure more than once. For coders who arent familiar with the procedure, finding the correct code may be difficult because its not a urology code.

The correct code for performing a spermatic cord block is 64425 (ilioinguinal, iliohypogastric nerves), says Jules Geltzeiler, MD, who practices with Shore Urology in Long Branch, N.J.

A spermatic cord block is performed for chronic orchialgia (608.9), explains Geltzeiler.

The spermatic cord block is a nerve block that works much the same way a nerve block for back pain works. Lets say you have something that is causing the pain, and the nerves tell your spine that theres pain there, Geltzeiler explains. Sometimes, theres no reason for the pain any more, but you still have it, so that the problem is really a chronic pain syndrome. The nerve block interrupts the pathway of the nerve, so that the cycle of pain can stop. This may need to be repeated intermittently, perhaps three or four times, says Geltzeiler.