Wiki Frenulotomy of penis

[jhold55@optonline.net]

I bill for Urology specialists and submitted a charge to HIP for CPT code 54164 (frenulotomy of penis) with ICD 10 CM code N47.8. Procedure was done in the provider's office. Charge was denied for incorrect place of service. Has anyone had this code denied for similar reasons.

 

[JenniferB7]

What place of service code did you use? If you used POS 11, then I would appeal the denial with a copy of the in-office procedure note. I would just make sure everything was correct on the claim form (correct POS code, correct locations, etc.) before submitting an appeal. I have had this issue with frenulectomy codes (on the tongue). Some insurance payers think that these types of services are only ever performed in an outpatient facility setting even though there are RVUs assigned for non-facility settings. I usually have no problems obtaining reimbursement on appeal.

Hope that helps!