How To Use CPT Code 53220

CPT 53220 describes the excision or fulguration of carcinoma of the urethra. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 53220?

CPT 53220 is used to describe the surgical procedure of partially or completely excising a tumor in the urethra or exposing it to electric current to destroy it. This code is used when the provider removes a malignant tumor in order to improve urination.

2. Official Description

The official description of CPT code 53220 is the excision or fulguration of carcinoma of the urethra.

3. Procedure

1. The provider prepares the patient and administers anesthesia.
2. An incision is made in the suprapubic area below the bladder to access the urethra.
3. The incision is extended to the level of the fascia and muscle.
4. The bladder is opened and clipped.
5. The neoplasm in the urethra is identified and partially or completely excised.
6. The urethral tumor may also be fulgurated using electrocautery.
7. A small skin opening is made and sutured to the urethral opening in the bladder for urine drainage.
8. A catheter is inserted into the urethra for healing and removed at a later date.
9. Bleeding is controlled and the incision is closed in layers using absorbable sutures.

4. Qualifying circumstances

CPT 53220 is performed on both males and females. It is used to remove a malignant tumor in the urethra and improve urination.

5. When to use CPT code 53220

CPT code 53220 should be used when the provider performs the excision or fulguration of a carcinoma in the urethra. It is important to accurately document the procedure and ensure that it meets the criteria for this specific code.

6. Documentation requirements

To support a claim for CPT 53220, the provider must document the following information:

• Patient’s diagnosis and the need for excision or fulguration of carcinoma of the urethra
• Details of the procedure performed, including the extent of excision or fulguration
• Date of the procedure
• Any complications or additional procedures performed
• Signature of the provider

7. Billing guidelines

When billing for CPT 53220, ensure that the procedure meets the criteria for this specific code. It is important to accurately document the procedure and any additional services provided. CPT code 53220 should not be reported with other codes unless they are performed in the previous seven days. Consider the location of the testing when coding these procedures.

8. Historical information

CPT 53220 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates to the code since its addition.

9. Examples

1. A provider performs a partial excision of a carcinoma in the urethra to improve urination in a male patient.
2. A provider uses electrocautery to fulgurate a malignant tumor in the urethra of a female patient.
3. A provider performs a complete excision of a carcinoma in the urethra to alleviate urinary symptoms in a male patient.
4. A provider performs a partial excision of a carcinoma in the urethra to prevent further spread of the tumor in a female patient.
5. A provider uses electrocautery to fulgurate a malignant tumor in the urethra of a male patient to improve urination.
6. A provider performs a complete excision of a carcinoma in the urethra to alleviate urinary symptoms in a female patient.
7. A provider performs a partial excision of a carcinoma in the urethra to prevent further spread of the tumor in a male patient.
8. A provider uses electrocautery to fulgurate a malignant tumor in the urethra of a female patient to improve urination.
9. A provider performs a complete excision of a carcinoma in the urethra to alleviate urinary symptoms in a male patient.
10. A provider performs a partial excision of a carcinoma in the urethra to prevent further spread of the tumor in a female patient.