How To Use CPT Code 54065

CPT 54065 describes the extensive destruction of lesion(s) on the penis using various methods such as laser surgery, electrosurgery, cryosurgery, chemosurgery, or surgical excision. 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 54065?

CPT 54065 is used to describe the extensive destruction of lesion(s) on the penis. This code encompasses the removal or destruction of various types of lesions, including condyloma, papilloma, molluscum contagiosum, and herpetic vesicle. The procedure may involve the use of chemical methods, electrodesiccation, cryosurgery, laser surgery, or surgical excision.

2. Official Description

The official description of CPT code 54065 is: ‘Destruction of lesion(s), penis (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), extensive (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery)’

3. Procedure

1. The provider begins by appropriately prepping, draping, and anesthetizing the patient, typically using local anesthesia.
2. Next, the provider identifies and marks the lesion(s) on the penis that require removal or destruction.
3. Depending on the specific technique chosen, the provider may apply a chemical to destroy the lesions, use a high-frequency electric current or laser to burn the lesions, or apply liquid nitrogen to freeze the lesions.
4. If surgical excision is performed, the provider makes an incision around the area of the lesion and removes it. The incision is then closed with absorbable sutures.
5. Chemical, electrodesiccation, cryosurgery, and laser surgery methods typically do not require sutures.

4. Qualifying circumstances

CPT 54065 is used for patients with extensive lesions on the penis, such as condyloma, papilloma, molluscum contagiosum, or herpetic vesicle. The procedure must be performed by a qualified healthcare professional and may involve the use of various techniques, including laser surgery, electrosurgery, cryosurgery, chemosurgery, or surgical excision.

5. When to use CPT code 54065

CPT code 54065 should be used when the provider performs extensive destruction of lesion(s) on the penis using methods such as laser surgery, electrosurgery, cryosurgery, chemosurgery, or surgical excision. It is important to note that this code is specifically for extensive lesions and should not be used for less extensive cases.

6. Documentation requirements

To support a claim for CPT code 54065, the provider must document the following information:

• Patient’s diagnosis and the need for extensive destruction of lesion(s) on the penis
• Specific method used for the destruction (e.g., laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical excision)
• Date of the procedure
• Details of the procedure, including the number and location of lesions treated
• Any complications or additional procedures performed
• Signature of the provider

7. Billing guidelines

When billing for CPT code 54065, ensure that the procedure performed involves the extensive destruction of lesion(s) on the penis using methods such as laser surgery, electrosurgery, cryosurgery, chemosurgery, or surgical excision. It is important to follow the specific guidelines for each method used. Additionally, be aware of any bundling or unbundling rules that may apply when reporting this code with other related codes.

8. Historical information

CPT code 54065 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates or changes to the code since its addition.

9. Examples

1. A provider performs extensive destruction of condyloma lesions on the penis using laser surgery.
2. A patient with multiple papilloma lesions on the penis undergoes extensive destruction using cryosurgery.
3. A provider uses chemosurgery to extensively destroy molluscum contagiosum lesions on the penis.
4. Using surgical excision, a provider removes extensive herpetic vesicle lesions on the penis.
5. A patient with extensive condyloma lesions on the penis undergoes destruction using electrosurgery.
6. Using laser surgery, a provider performs extensive destruction of papilloma lesions on the penis.
7. A patient with molluscum contagiosum lesions on the penis undergoes extensive destruction using cryosurgery.
8. A provider uses chemosurgery to extensively destroy herpetic vesicle lesions on the penis.
9. Using surgical excision, a provider removes extensive condyloma lesions on the penis.
10. A patient with multiple papilloma lesions on the penis undergoes destruction using electrosurgery.