Urology Coding Alert

Question: The patient had a scrotal abscess. My urologist performed incision and drainage (I&D) of the scrotal abscess, along with a placement of vacuum-assisted closure (VAC) dressing. The patient was placed under anesthesia in dorsal lithotomy. They were prepped and draped. My urologist excised abnormal skin at both sites. There were a few small actual pockets of purulence, but for the most part it was edematous tissue that was purulent. There was a channel that could be connected between the two sites of excision of the skin. There was a small amount of tracking posteriorly, as well as a short amount of tracking to the left upper scrotum. No large pockets of purulence were encountered. Scrotal contents were not exposed. My urologist encountered a few bleeders, which they cauterized with good effect. They irrigated with gentamicin solution and excised some of the necrotic tissue on the surface as much as possible. My urologist elected to leave a VAC dressing, which was cut into two pieces. One was placed posteriorly and one in the main incision. My urologist used 0 Vicryl to help partially reapproximate the wound edges to help with the adhesive layer. My urologist prepped the skin after shaving and applied the adhesive later across the wound. They placed the suction disc and turned on the suction. No leak was detected. There were a few spots where it looked as though the edge of the adhesive layer was bunched up, and my urologist reinforced those spots. The posterior incision came fairly close to the anus. They were able to make the application there, however. The patient was then awakened and taken recovery in good condition. There are no complications, and they tolerated the procedure well. All counts were correct. Wound VAC showed no evidence of leak at the end of the case. Which codes should I report on my claim?

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Answer: You should report 55100 (Drainage of scrotal wall abscess) and 97605 (Negative pressure wound therapy (eg, vacuum assisted drainage collection), utilizing durable medical equipment (DME), including topical application(s), wound assessment, and instruction(s) for ongoing care, per session; total wound(s) surface area less than or equal to 50 square centimeters) on your claim. After surgery, you may bill separately for negative pressure therapy since it is not a part of postoperative global care.

Don’t miss: Code 55100 is limited to drainage of an abscess in the scrotal wall and does not include exploration or I&D of an abscess in the internal space of the scrotum or its contents.