Urology Coding Alert

You Be the Coder:

Bridge the Adhesion Terminology Gap

Test your coding knowledge. Determine how you would code this situation before looking at the box below for the answer. Question: How should I code a circumcision with the removal of a skin bridge? UCA Subscriber  

  Answer: Don't let the term ""skin bridge"" throw you off it's just a fancy term for an adhesion on the glans penis. Adhesions can present from the undersurface of the foreskin to the glans in an uncircumcised penis or between the glans penis and the penile corona in a circumcised penis. But it sounds as if your urologist detached adhesions between the glans penis and foreskin prior to circumcision which means the appropriate CPT Codes is circumcision CPT 54161 (Circumcision surgical excision other than clamp device or dorsal slit; except newborn). If however the detachment of the adhesions constituted a significant part of the work involved in completing the procedure or the adhesions were actually along the shaft of the penis rather than between the glans and the foreskin you should report 54162-59 (Lysis or excision of penile post-circumcision adhesions; Distinct procedural service) in addition to 54161. Modifier -59 will indicate to the carrier that the lysis of adhesions was performed in a distinct different location from that of the circumcision.  
 

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