Wiki CPT Code for Penile Ring

[debbiesom]

My doctor removed a Penile Ring by cutting the ring. Any suggestions on CPT code? Thanks

On exam, penis is very edematous but does not appear necrotic. He is in pain from this. There is the above described stainless steel penile ring at the base of the shaft. Over the next 1 hour and a half, I used a combination of diamond and carbide discs on the ring cutter to make 2 cuts on the ring, removing a smaller section and then making me able to remove the entire ring. Special care was used to protect the skin and ice water was used for irrigation. He was given 4 mg of intravenous morphine for analgesia. Using Raptor scissors, I was able to cut the ring after grinding incisions on the 2 areas ventral into the right lateral. The material was very hard. The reticulating saw would not work on it. After removal of the ring, the patient felt instant relief and the swelling began to decrease. I was able to squeeze some of the edema down. There was some skin abrasions which were cleansed and the patient was told to place Neosporin on. He was advised against using penile rings in the future. There was a lot of pain but he otherwise tolerated it well.

 

[SharonCollachi]

I couldn't find anything within the last 5 years, but prior to that, everything says there is no code for cutting off a ring from finger or penis, without an incision (incision & removal of foreign body). You could use an unlisted code, or you could use the E&M code plus an extended time code (99354, 99355), and I would probably send it on paper with the report attached.

 

[Jessim929]

There actually isn't a code for that, only an E&M, and I would DEFINITELY send the records! (one of my docs had a case where they had to use an ortho saw to get it off.)

 

[maryir]

OK - know this is an older post but.... The patient was brought to OR - use CPT 55899?

The patient was brought into the operating room and anesthesia was induced after an anesthesia time out. The patient was then placed in supine position and all pressure points were padded. The surgical area was prepped and draped in the usual sterile fashion. Preoperative antibiotics (Kefzol) was given. A time out was performed.
Examination under anesthesia revealed marked edema of the penis that was unable to be reduced enough to allow the penis ring to be removed. Therefore, we proceeded to cut through the metal ring systematically using a craniotomy drill while protecting the penile skin using a small malleable between the skin and the ring. Irrigation with cold saline was used during the drilling to prevent thermal injury. Once we were able to divide the metal ring in two separate locations this allowed us to separate the two halves of the ring and remove it. We then irrigated and inspected the skin which was macerated but intact without evidence of laceration or thermal injury. After applying compression to the penis we were able to reduce the penile edema and noted there was a paraphimosis present. The paraphimosis was reduced and we placed a 16 Fr Foley with with immediate return of clear yellow urine (1500mL) which was sent for Urine tox and UA/UCx. 10cc 1% lidocaine was placed as dorsal penile nerve block at the end of the case. Antibiotic ointment was applied to the skin and a compressive dressing was placed around the penis.
The patient was awoken from anesthesia, extubated and was taken to the PACU in stable condition.