Results 1 to 2 of 2

Separate Procedure 55520+49505

  1. Default Separate Procedure 55520+49505
    Medical Coding Books
    It is my understanding that 55520 (Excision of lesion of spermatic cord (separate procedure)) is not billable with an inguinal hernia repair. The NCCI edits do not show any bundling issues, however, it's listed as a separate procedure which indicates that it is not normally billed separately with another procedure.

    Am I right about this rule, or can I bill 55520 with 49505?

    Thank you for your help!

  2. Smile
    Per CPT Assistant, September 2000, Vol 10 Issue 9

    "Code 55520, Excision of lesion of spermatic cord (separate procedure), is designated as a "separate procedure." Codes with the "separate procedure" designation normally would not be additionally reported when the procedure or service is performed as an integral component of another procedure or service. However, when codes designated as "separate procedures" are performed independently, unrelated or distinct from other procedure(s)/service(s) provided, then it would be appropriate to separately report the separate procedure. Modifier '-59,' Distinct Procedural Service, would be appended to code 55520 to indicate that the excision of the spermatic cord lesion is a separate, distinct procedure from the inguinal hernia repair performed at the same surgical session."

    So based on the above, I do code the 55520 - 59 with the inguinal hernia repair. Do all payers pay it? No. But until there is documentation somewhere to overturn the above, I will still code it.

    Hope this helps.

Similar Threads

  1. What if both codes are Separate Procedure ?
    By betsycpcp in forum Orthopaedics
    Replies: 0
    Last Post: 04-04-2013, 05:14 AM
  2. Separate procedure- all or part?
    By LadyAg in forum Gastroenterology
    Replies: 2
    Last Post: 01-27-2012, 09:15 PM
  3. Separate Procedure?
    By SUEV in forum General Surgery
    Replies: 2
    Last Post: 12-02-2011, 02:33 PM
  4. Separate Procedure
    By coderguy1939 in forum Outpatient Facilities
    Replies: 4
    Last Post: 02-08-2010, 10:02 AM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.