How To Use CPT Code 55060

CPT 55060 describes the repair of a tunica vaginalis hydrocele using the bottle technique. 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 55060?

CPT 55060 can be used to describe the surgical procedure performed to repair a tunica vaginalis hydrocele. This procedure involves removing the fluid-filled sac from the membrane covering the testis, or testicle, to alleviate pain or discomfort. The provider utilizes the bottle technique, which includes incising the hydrocele and turning it inside out.

2. Official Description

The official description of CPT code 55060 is: ‘Repair of tunica vaginalis hydrocele (Bottle type).’ This code represents the surgical repair of a hydrocele using the bottle technique.

3. Procedure

1. The provider begins by making an incision in the scrotum after the patient is properly prepped and anesthetized.
2. They then identify the hydrocele and proceed to incise it.
3. The testis is delivered after the hydrocele is incised.
4. The provider everts the hydrocele sac, turning it inside out.
5. The hydrocele sac is attached behind the testis to the cord structures.
6. The testis is implanted back into the scrotum, ensuring there is no blockage in the blood supply.
7. A drain is placed, and the incision is closed with sutures in layers.

4. Qualifying circumstances

CPT 55060 is performed on patients with a tunica vaginalis hydrocele, which is a fluid collection within a sac in the scrotal area. The procedure is indicated to relieve pain or discomfort caused by the hydrocele. It is important to note that this code represents a unilateral service, meaning it is performed on only one side of the scrotum. If the procedure is performed bilaterally, the appropriate modifier should be appended.

5. When to use CPT code 55060

CPT code 55060 should be used when a provider performs the repair of a tunica vaginalis hydrocele using the bottle technique. It is important to ensure that the procedure is documented accurately and meets the criteria outlined in the code description.

6. Documentation requirements

To support a claim for CPT 55060, the provider must document the following information:

• Patient’s diagnosis of a tunica vaginalis hydrocele
• Description of the procedure performed, including the use of the bottle technique
• Date of the procedure
• Details of the surgical approach and any additional procedures performed
• Any complications or unexpected findings
• Signature of the provider

7. Billing guidelines

When billing for CPT 55060, it is important to ensure that the procedure meets the criteria outlined in the code description. If the procedure is performed bilaterally, the appropriate modifier should be appended. It is also important to follow payer preferences regarding modifiers. Additionally, it is important to review any specific billing guidelines provided by the payer to ensure accurate and appropriate reimbursement.

8. Historical information

CPT 55060 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates to the code since its addition.

9. Examples

1. A provider performs a repair of a tunica vaginalis hydrocele using the bottle technique on the right side of the scrotum.
2. A patient presents with a tunica vaginalis hydrocele causing significant discomfort. The provider performs a repair using the bottle technique on the left side of the scrotum.
3. A 45-year-old male undergoes a repair of a tunica vaginalis hydrocele using the bottle technique on the right side of the scrotum. The procedure is performed to alleviate pain and discomfort.
4. A provider performs a repair of a tunica vaginalis hydrocele using the bottle technique on the left side of the scrotum. The patient had been experiencing discomfort for several months.
5. An elderly patient presents with a large tunica vaginalis hydrocele. The provider performs a repair using the bottle technique on the right side of the scrotum to relieve the patient’s discomfort.
6. A 30-year-old male undergoes a repair of a tunica vaginalis hydrocele using the bottle technique on the left side of the scrotum. The procedure is performed to alleviate pain and improve the patient’s quality of life.
7. A provider performs a repair of a tunica vaginalis hydrocele using the bottle technique on the right side of the scrotum. The patient had been experiencing discomfort and swelling in the scrotal area.
8. A patient presents with a recurrent tunica vaginalis hydrocele. The provider performs a repair using the bottle technique on the left side of the scrotum to address the issue.
9. An adult male undergoes a repair of a tunica vaginalis hydrocele using the bottle technique on the right side of the scrotum. The procedure is performed to alleviate pain and improve the patient’s overall well-being.
10. A provider performs a repair of a tunica vaginalis hydrocele using the bottle technique on the left side of the scrotum. The patient had been experiencing discomfort and difficulty with daily activities.