please help with coding "Feminizing genitoplasty" on a 3 month old

maryairving

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I haven't worked in pedi uro in years and an op note came across my desk to review/correct the coding. In addition the pt had a bi-lateral orchiectomy and cystoscopy which were coded 54520-50 and 52000 respectively.

The origional CPT billed was 55970 with a op note attached. It was denied as not a benefit. I don't think the carrier (Medicaid) is getting it. I believe the code is too general and the service was to correct "severe partial androgen insensitivity syndrom".

After reading the note there were two additional services rendered. I'm thinking the code could be broken down to: 1) 56805 w/mod 50 - Clitouoplasty
2) 1313? with mod 22 (???) - Labiaplasty.

Am I way off?
 
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