Urology Coding Alert

Question: How do I code a bilateral non-scalpel vasectomy? What about a reversal?

Wisconsin Subscriber

Answer: Code 55250 (vasectomy, unilateral or bilateral [separate procedure], including postoperative semen examination[s]) is for a vasectomy, but there is no separate code for a non-cutting procedure. As long as you are ligating the vas deferens, 55250 is appropriate for any technique or combination of techniques. If the non-scalpel technique takes a significant additional amount of time, append modifier -22 (unusual procedural services).

The non-scalpel procedure is very similar to a traditional vasectomy, but there are no incisions or stitches, so healing is faster. A puncture is made in the scrotum with a pointed clamp, and the two vasa deferentia are lifted out. The vasa are cut, and a section of each may be removed as well. The two cut ends are cauterized and also may be tied or clipped. Code 55250 is bilateral, which means that the urologist can be paid only once for doing both sides. A reversal is coded 55400 (vasovasostomy, vasovasorrhaphy), which is the same code you would use for reversal of a standard vasectomy.