How To Use CPT Code 54901

CPT 54901 describes the surgical procedure known as epididymovasostomy, which involves the connection of the epididymis to the vas deferens. 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 54901?

CPT 54901 is a code used to describe the surgical procedure called epididymovasostomy. This procedure involves connecting the epididymis, a tubular duct behind the testis, to the vas deferens, which carries sperm from the testes to the urethra. The purpose of this procedure is to correct a blockage of sperm flow from the epididymis to the vas deferens. It is important to note that this procedure is performed bilaterally, meaning it is done on both sides.

2. Official Description

The official description of CPT code 54901 is: ‘Epididymovasostomy, anastomosis of epididymis to vas deferens; bilateral.’ This code specifically refers to the surgical connection of the epididymis to the vas deferens on both sides.

3. Procedure

1. The surgeon begins by making an incision in the scrotum and accessing the testis with its epididymis.
2. Next, the surgeon explores and excises the vas deferens.
3. The surgeon then opens the area of concern in the epididymis and brings out the tubule from the epididymis, transecting it.
4. The opened epididymal tubule is then connected to the excised end of the vas deferens using small simple sutures.
5. To strengthen the connection, the surgeon places an outer layer of radially placed sutures around the circumference of each connection.
6. A drain is placed in the scrotum, and the incision is closed. The same procedure is repeated on the opposite side.

4. Qualifying circumstances

CPT 54901 is performed on patients who have a blockage of sperm flow from the epididymis to the vas deferens. This procedure is appropriate for individuals who require the surgical connection of the epididymis to the vas deferens on both sides. It is important to note that this procedure is performed by a surgeon and requires appropriate prepping and anesthesia.

5. When to use CPT code 54901

CPT code 54901 should be used when a surgeon performs the epididymovasostomy procedure to connect the epididymis to the vas deferens bilaterally. This code is specifically for cases where the procedure is performed on both sides. It is important to accurately document the bilateral nature of the procedure to ensure proper coding and billing.

6. Documentation requirements

To support a claim for CPT 54901, the surgeon must document the following information:

• Patient’s diagnosis and the need for epididymovasostomy
• Details of the procedure, including the incision, exploration, excision, connection of the epididymis to the vas deferens, and closure
• Documentation of the bilateral nature of the procedure
• Any additional relevant information, such as complications or additional procedures performed
• Signature of the surgeon performing the procedure

7. Billing guidelines

When billing for CPT 54901, ensure that the procedure is performed bilaterally, connecting the epididymis to the vas deferens on both sides. It is important to accurately document the bilateral nature of the procedure to support proper billing. Additionally, follow any specific guidelines provided by the payer or insurance company to ensure accurate reimbursement.

8. Historical information

CPT 54901 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 surgeon performs a bilateral epididymovasostomy to correct a blockage of sperm flow in a patient.
2. A patient with a history of infertility undergoes a bilateral epididymovasostomy to improve the chances of conception.
3. A surgeon performs a bilateral epididymovasostomy on a patient who experienced a previous vasectomy and now desires to restore fertility.
4. A patient with a congenital abnormality undergoes a bilateral epididymovasostomy to correct the anatomical issue.
5. A surgeon performs a bilateral epididymovasostomy on a patient who experienced a traumatic injury to the reproductive system.
6. A patient with a history of failed vasectomy reversal undergoes a bilateral epididymovasostomy as an alternative procedure.
7. A surgeon performs a bilateral epididymovasostomy on a patient with a known blockage in the epididymis and vas deferens.
8. A patient with a history of recurrent epididymal cysts undergoes a bilateral epididymovasostomy to alleviate symptoms and prevent future cyst formation.
9. A surgeon performs a bilateral epididymovasostomy on a patient with a congenital absence of the vas deferens.
10. A patient with a history of chronic epididymitis undergoes a bilateral epididymovasostomy to improve symptoms and prevent future flare-ups.