Learn Which Code to Assign for a Varicocele Diagnosis
Question: A patient presented to the urologist with pain in their scrotum. The urologist performed physical examination of the patient’s scrotum and noted there weren’t any visual injuries. The physician then performed a Doppler ultrasound (US) to check for presence of hydrocele, varicocele, or other scrotal fluid collection bilaterally. The provider discovered a varicocele on the left side of the scrotum, which is documented in the encounter note. The physician scheduled the patient for a varicocelectomy. What codes should I report for this encounter? Ohio Subscriber Answer: You’ll use 93975 (Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; complete study) to report the Doppler US of the scrotum. Assign I86.1 (Scrotal varices) to report the varicocele diagnosis. To locate the diagnosis code, look for Varicocele (scrotum) in the ICD-10-CM Alphabetic Index, which refers to I86.1. When you turn to the Tabular List, you’ll find that varicocele is an additional diagnosis term listed under the code. A varicocele is a condition in which the veins within the scrotum become enlarged. This leads to blood pooling in the veins rather than circulating out of the scrotum. Mike Shaughnessy, BA, CPC, Production Editor, AAPC
