IPP Replacement or Repair?

sxcoder1

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Surgical Technique: After informed consent and adequate anesthesia patient was placed in the supine position. The penis scrotum perineum and abdomen were scrubbed with Betadine scrub for 10 minutes and the area was dried and reprepped with ChloraPrep twice. Area was sterilely draped. The area of the reservoir was identified and an oblique incision made over it. Cautery was used to maintain hemostasis and power was turned down to 20. The reservoir the reservoir was delivered wrapped in antibiotic covered sponge and towel and set aside the capsule was next incised posteriorly the external Bleich was opened muscle splitting incision performed in the retroperitoneum entered pocket made in the retroperitoneum and the reservoir placed in their the tissue was closed in 3 layers with 2-0 PDS tightening around the the tubing. The Scarpa's fascia was reapproximated with 3-0 Vicryl and skin closure in 2 layers with 4-0 Monocryl next the penoscrotal incision was removed was opened and dissection proceeded both to the right and left of the urethra and the tubing followed into the retro into the corpora each corpora corporotomy performed on each side and the prosthesis delivered each area was measured on the left and right at approximately 2111+10 the areas were redilated and it was elected to proceed with a 21.5 after placing the 20 and finding it slightly short at 21.5 went in and was starting to buckle but appeared to straighten out. The tunica was reapproximated with 2-0 PDS. Tissue was closed in 3 layers with 3-0 Vicryl and then 2 layers of 4-0 Monocryl sterile Dermabond applied the penis was pumped up and down the corpora the prosthesis went to the all the way to the end to the maximum position and the whole Corp. the home prosthesis had been irrigated with antibiotic solution before placing it in a could not be moved further up. It was felt that any glanduloplasty may cause damage to the sensation and the glans was sitting straight on the penis. Tissue was closed as noted and patient taken recovery in satisfactory condition.

Would you say this is 54410 (remove & replace all components of IPP) or 54408 (repair of IPP)? It looks like he repositioned the reservoir, but it looks like he replaced the cylinders I think? Thank you!
 
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I would suggest 54410-52 for your clinical scenario indicating you did not remove all of the components and did not replace all of the components, leaving the initial reservoir in place.
 
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