How To Use CPT Code 54220

CPT 54220 describes the procedure of irrigating the corpora cavernosa to treat priapism, a condition that causes a persistent erect penis. This article will cover the description, official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 54220?

CPT 54220 can be used to describe the procedure of irrigating the corpora cavernosa to treat priapism. Priapism is a painful condition where the penis remains erect and does not return to its flaccid state. This procedure involves drawing out blood from the corpora cavernosa using a large bore needle and irrigating the area with a saline liquid. The provider may repeat this procedure as necessary to resolve the abnormal erection.

2. Official Description

The official description of CPT code 54220 is: ‘Irrigation of corpora cavernosa for priapism.’

3. Procedure

1. To perform the procedure, the provider preps and anesthetizes the patient.
2. Using a large bore needle, the provider draws out blood from the corpora cavernosa, which is the sponge-like tissue in the penile shaft that contains most of the blood during an erection.
3. The provider then irrigates the area with a saline liquid, flushing out the remaining blood and resolving the abnormal erection.
4. If necessary, the provider may repeat the irrigation procedure to ensure the priapism is fully resolved.

4. Qualifying circumstances

This procedure is typically performed to treat priapism, a condition characterized by a persistent and painful erection. The provider may choose to perform this procedure when other conservative measures have failed to resolve the priapism. It is important to note that the provider must assess the patient’s condition and determine the appropriateness of the procedure based on the individual circumstances.

5. When to use CPT code 54220

CPT code 54220 should be used when the provider performs the irrigation of the corpora cavernosa to treat priapism. It is important to ensure that the procedure is medically necessary and appropriate for the patient’s condition. This code should not be used for other procedures or conditions unrelated to priapism.

6. Documentation requirements

To support a claim for CPT code 54220, the provider must document the following information:

• Patient’s diagnosis of priapism
• Preparation and anesthesia provided
• Details of the procedure, including the use of a large bore needle and saline irrigation
• Number of times the procedure was performed, if applicable
• Outcome of the procedure and resolution of the priapism
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT code 54220, ensure that the procedure is performed to treat priapism and that the documentation supports the medical necessity of the procedure. It is important to follow the specific guidelines provided by the payer and use the appropriate modifiers, if required. CPT code 54220 should not be reported with other codes unless medically necessary and supported by documentation.

8. Historical information

CPT code 54220 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 urologist performing the irrigation of the corpora cavernosa to treat priapism in a patient.
2. A surgeon using CPT code 54220 to bill for the procedure of irrigating the corpora cavernosa for priapism.
3. A patient with priapism undergoing the irrigation procedure to resolve the persistent erection.
4. A provider documenting the details of the irrigation procedure performed to treat priapism in the patient’s medical record.
5. A medical coder assigning CPT code 54220 based on the documentation provided by the provider for the irrigation procedure.
6. A healthcare facility billing for the irrigation of the corpora cavernosa using CPT code 54220.
7. A patient receiving the irrigation procedure as part of the treatment for priapism.
8. A provider discussing the risks and benefits of the irrigation procedure with the patient before performing it.
9. A medical billing specialist ensuring that the documentation supports the use of CPT code 54220 for the irrigation procedure.
10. A healthcare auditor reviewing the medical records to ensure the appropriate use of CPT code 54220 for the irrigation procedure.