Urology Coding Alert
Beware of 'And' Language
Question: I have a physician who wants to bill a paraphimosis reduction. He did this in office on a patient with significant paraphimosis. I do not want to bill 54450 because it states “lysis of adhesions and stretching,” not “lysis of adhesions or stretching.” Is there a more appropriate code for this procedure, or would modifier 52 be applicable?
Minnesota Subscriber
Answer: The presence of adhesions is not a requirement for reporting 54450 (Foreskin manipulation including lysis of preputial adhesions and stretching). The procedure of reducing a paraphimosis always includes some stretching of the foreskin and lysis of adhesions. This is the correct code to report for this case. You should use diagnosis code 605 (Redundant prepuce and phimosis) [N47.2 {Paraphimosis} in ICD-10].
Urology Coding Alert
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