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Wiki Partial Circumcision

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catharine

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Hi all,
A little help please....

I coded 54161 for this procedure:
The patient having urinary incontinence and we could see that the distal aspect of the head of the phallus and a portion of the foreskin was irritated, he wanted this irritated area of the foreskin excised. I made a circumferential incision around this irritated area and excised this area of foreskin leaving him with a fairly good amount of foreskin. The distal part of the penile skin was the reapproximated to the foreskin with interrupted sutures. (this was done with 54830 and 55040 as well)

Someone didn't agree with the 54161 and changed the code to 54450 which I believe is incorrect.

The patient then returned 1 month later and had the circ completed. I billed the 54161 again as i didn't think the 54163 was a good fit since only a portion was removed last time. and it is also getting denied as within global.

My question is how should I have billed the first partial circ., and should I have billed the second circ as a 54163-78 or 54161-78

thank you.
 
I agree with 54161 for the first circumcision. For the second procedure bill 54163 for the completion of the circumcision.
From Michael A/ Ferragamo MD, FACS
 
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