How To Use CPT Code 54690

CPT 54690 describes the laparoscopic surgical procedure known as orchiectomy, which involves the removal of one or both testicles. This article will cover the description, official details, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 54690?

CPT 54690 is a code used to describe a laparoscopic surgical procedure called orchiectomy. This procedure involves the removal of one or both testicles using a laparoscope, a small instrument that allows the provider to view and access the structures within the abdomen and pelvis.

2. Official Description

The official description of CPT code 54690 is: ‘Laparoscopy, surgical; orchiectomy.’

3. Procedure

1. During the orchiectomy procedure, the patient is appropriately prepped and anesthetized.
2. The provider makes an incision at the umbilicus (navel) and inserts a laparoscope to visualize the abdominal structures.
3. A trocar is then placed into the abdomen to create a port for the surgical instruments.
4. The provider identifies and removes the testis and its associated structures through the abdominal space using the laparoscope and trocar port.
5. If necessary, the provider may place packing inside the empty scrotum and preserve the ilioinguinal nerve and other vessels in the area.
6. In some cases, an artificial testis may be placed in the scrotum.
7. The trocars are removed, and the incision is closed with sutures.

4. Qualifying circumstances

CPT 54690 is typically performed when a patient has an undescended, injured, or diseased testicle that needs to be removed. It may also be performed in cases of testicular tumors. The procedure is carried out by a provider who is skilled in laparoscopic surgery and has the necessary training and qualifications to perform orchiectomies.

5. When to use CPT code 54690

CPT code 54690 should be used when a laparoscopic orchiectomy is performed. It is important to note that this code specifically applies to the surgical removal of the testicles using a laparoscope. If the procedure is performed through an open incision or using a different approach, a different CPT code should be used.

6. Documentation requirements

When reporting CPT code 54690, the following documentation should be included:

• Reason for the orchiectomy, such as an undescended testicle or testicular tumor
• Details of the laparoscopic approach used
• Date of the procedure
• Specific findings during the procedure
• Any additional procedures performed during the same operative session
• Any complications or unexpected events that occurred
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT code 54690, it is important to ensure that the procedure was performed using a laparoscopic approach. If the procedure was performed through an open incision or using a different technique, a different CPT code should be used. It is also important to follow any specific billing guidelines provided by the payer or insurance company.

8. Historical information

CPT code 54690 was added to the Current Procedural Terminology system on January 1, 2000. There have been no updates or changes to the code since its addition.

9. Examples

1. A patient undergoes a laparoscopic orchiectomy to remove an undescended testicle.
2. A testicular tumor is discovered during a laparoscopic procedure, and the provider performs an orchiectomy to remove the affected testicle.
3. A patient with a history of testicular injury undergoes a laparoscopic orchiectomy to address ongoing complications.
4. A laparoscopic orchiectomy is performed on a patient with a diseased testicle that is causing significant pain and discomfort.
5. A patient with a genetic condition requiring the removal of both testicles undergoes a laparoscopic orchiectomy.
6. A laparoscopic orchiectomy is performed on a patient with testicular cancer to remove the affected testicle and prevent further spread of the disease.
7. A patient with an undescended testicle undergoes a laparoscopic orchiectomy to correct the condition and improve fertility.
8. A laparoscopic orchiectomy is performed on a patient with testicular torsion to relieve pain and prevent further complications.
9. A patient with a history of testicular trauma undergoes a laparoscopic orchiectomy to address ongoing pain and discomfort.
10. A laparoscopic orchiectomy is performed on a patient with a testicular mass to determine the nature of the mass and provide appropriate treatment.