How To Use CPT Code 55100

CPT 55100 describes the procedure for draining a scrotal wall abscess. This article will cover the official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 55100?

CPT 55100 is used to describe the drainage of a scrotal wall abscess. This procedure involves making an incision into the scrotum directly over the abscess and draining the pus. It does not include exploration or incision and drainage of an abscess in the internal space of the scrotum or its contents.

2. Official Description

The official description of CPT code 55100 is: ‘Drainage of scrotal wall abscess.’

3. Procedure

1. The provider prepares the patient and administers anesthesia.
2. An incision is made into the scrotum directly over the abscess.
3. The provider drains the pus from the abscess.
4. The site is flushed with sterile saline.
5. Antibiotics are applied to the site.
6. The site is packed with gauze.

4. Qualifying circumstances

CPT 55100 is limited to the drainage of an abscess in the scrotal wall. It does not include exploration or incision and drainage of an abscess in the internal space of the scrotum or its contents.

5. When to use CPT code 55100

CPT code 55100 should be used when the provider is draining a scrotal wall abscess. It should not be used for abscesses in the internal space of the scrotum or its contents.

6. Documentation requirements

To support a claim for CPT 55100, the provider must document the following information:

• Patient’s diagnosis and the presence of a scrotal wall abscess
• Date of the procedure
• Details of the procedure, including the incision, drainage of pus, flushing with sterile saline, application of antibiotics, and packing of the site
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 55100, ensure that the procedure performed is limited to the drainage of a scrotal wall abscess. It should not include exploration or incision and drainage of an abscess in the internal space of the scrotum or its contents. There are no specific guidelines regarding reporting CPT 55100 with other codes.

8. Historical information

CPT 55100 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 drains a scrotal wall abscess in a patient with an infection.
2. An abscess in the scrotal wall is drained by a healthcare professional.
3. A patient undergoes a procedure to drain a scrotal wall abscess.
4. A provider performs the drainage of a scrotal wall abscess in a patient with a localized infection.
5. A scrotal wall abscess is drained by a healthcare professional to treat an infection.
6. A patient with a scrotal wall abscess undergoes a procedure to drain the abscess.
7. A provider performs the drainage of a scrotal wall abscess in a patient with an infected pocket of pus.
8. An abscess in the scrotal wall is drained by a healthcare professional to alleviate symptoms.
9. A patient undergoes a procedure to drain a scrotal wall abscess and promote healing.
10. A provider drains a scrotal wall abscess in a patient with an infected sac or pocket.