How To Use CPT Code 54420

CPT 54420 describes a surgical procedure known as corpora cavernosa-saphenous vein shunt, which is performed to relieve pain caused by priapism. This article will provide an overview of CPT code 54420, including its official description, the procedure involved, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and similar codes.

1. What is CPT Code 54420?

CPT 54420 is a code used to describe the surgical procedure known as corpora cavernosa-saphenous vein shunt. This procedure involves creating a passage between the corpora cavernosa and the saphenous vein to allow blood to flow freely and relieve pain caused by priapism. The shunt can be created unilaterally or bilaterally, depending on the patient’s condition.

2. Official Description

The official description of CPT code 54420 is: ‘Corpora cavernosa-saphenous vein shunt (priapism operation), unilateral or bilateral.’

3. Procedure

1. The surgical procedure begins with the patient being appropriately prepped and anesthetized.
2. The provider then creates a shunt, or passage, to correct priapism, which is an erection of the penis that lasts for an unusually long time.
3. An incision is made in the groin area, and the saphenous vein is harvested.
4. The provider dissects the vein free of its attachments, creating a free segment of about eight to ten centimeters in length.
5. An elliptical or oval window is formed through the deep fascia of the penis and the tunica albuginea.
6. The free end of the distal portion of the saphenous vein is pulled through a subcutaneous tunnel using hemostats.
7. The provider then anastomoses the end of the saphenous vein to the elliptical defect in the corpus cavernosum using sutures.
8. This creates a channel for blood to flow from the penis to the femoral vein through the saphenous vein segment, reducing the rigidity of the penis and relieving pain caused by priapism.

4. Qualifying circumstances

CPT 54420 is performed on patients who experience priapism, which is a painful condition characterized by a prolonged erection of the penis. The procedure is indicated when other conservative treatments have failed to relieve the pain. It is important to note that this procedure should only be performed by a qualified healthcare professional with the necessary expertise in urological surgery.

5. When to use CPT code 54420

CPT code 54420 should be used when a corpora cavernosa-saphenous vein shunt is performed to relieve pain caused by priapism. It is important to ensure that the procedure is medically necessary and that other conservative treatments have been unsuccessful before resorting to this surgical intervention.

6. Documentation requirements

To support a claim for CPT code 54420, the healthcare professional must document the following information:

• Patient’s diagnosis of priapism and the need for the corpora cavernosa-saphenous vein shunt
• Details of the surgical procedure performed, including whether it was unilateral or bilateral
• Date of the procedure
• Any complications or additional procedures performed
• Signature of the healthcare professional performing the procedure

7. Billing guidelines

When billing for CPT code 54420, it is important to ensure that the procedure was performed by a qualified healthcare professional and that the documentation supports the medical necessity of the shunt. It is also important to follow any specific billing guidelines provided by the payer. CPT code 54420 should not be reported with other codes unless additional procedures were performed during the same session.

8. Historical information

CPT code 54420 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 a corpora cavernosa-saphenous vein shunt unilaterally to relieve pain caused by priapism in a patient with sickle cell disease.
2. A surgeon performing a corpora cavernosa-saphenous vein shunt bilaterally to relieve pain caused by priapism in a patient with trauma-related priapism.
3. A urologist performing a corpora cavernosa-saphenous vein shunt unilaterally to relieve pain caused by priapism in a patient with priapism due to malignancy.
4. A surgeon performing a corpora cavernosa-saphenous vein shunt unilaterally to relieve pain caused by priapism in a patient with priapism due to other specified causes.
5. A urologist performing a corpora cavernosa-saphenous vein shunt bilaterally to relieve pain caused by priapism in a patient with priapism due to other causes.
6. A surgeon performing a corpora cavernosa-saphenous vein shunt unilaterally to relieve pain caused by priapism in a patient with priapism of unknown cause.
7. A urologist performing a corpora cavernosa-saphenous vein shunt unilaterally to relieve pain caused by priapism in a patient with priapism due to medication side effects.