Urology Coding Alert

Question: A patient has had an inguinal hernia repair preformed at another facility. He presents to our facility because of intense testicular pain. The patient is found to have testicular atrophy and an infected groin mesh (hernia was repaired with mesh). The general surgery team removed the infected mesh and redid the inguinal hernia repair. The general surgery team made an inguinal incision and cleared away dense scar tissue, which extended down into the testicle. The general surgery team pushed the testicle up into the wound. The urology team was then called in to perform an orchiectomy. The remainder of he procedure (i.e., closure) was performed by the general surgery team. The CPT code I want to report is 54520 because this was definitely not a radical procedure. Because the urology team did not open or close the patient, should I append a -52 modifier to the 54520?

Georgia Subscriber

Answer: It would indeed be appropriate in this case to append the -52 modifier (reduced services) to code 54520 (orchiectomy, simple, with or without testicular prosthesis, scrotal or inguinal approach). Without the exposure or closure, the urologists service is significantly reduced. Its a good idea on sequential or other multi-physician procedures like this to coordinate coding with the other physician to make sure that his charges will not create an inadvertent conflict.