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Thread: Penile injection 54235

  1. #1
    Join Date
    Apr 2007
    Palo Alto

    Default Penile injection 54235

    AAPC: Back to School
    I was hoping someone would be able to answer this for me and possibly have some documentation to support reasoning.

    A provider is billing for 54235 - Injection of corpora cavernosa with pharmacologic agents. In his note he states the patient does the injection under his supervision. I do not agree the provider can bill for the injection since he was not the one performing the procedure. They lay descripition states "The physician injects medication into the penis to treat erectile dysfunction. After placing a constricting rubber band around the penis, the physician passes a needle into the body of the penis and aspirates a small quantity of blood."

    My interpretation of this is the procedure must be performed by the provider in order to bill for it. I am unable to locate any documentation that specifically states it is not a billable procedure if the patient does the injection. I have included the documentation where the provider states the patient performed the injection.

    If anyone has any documentation for this, it is greatly appreciated.

    Careful instructions were given over a counseling session that was most of the 20 minute visit and he injected himself in the right corpus cavernosum successfully with 10 mcg of alprostadil.


  2. #2


    if the PATIENT did the injection, the PHYSICIAN cannot bill for it

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