How To Use CPT Code 55175

CPT 55175 describes a procedure known as scrotoplasty, which involves the repair of a simple defect in the scrotum. 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 55175?

CPT 55175 is used to describe a surgical procedure that repairs a simple defect in the scrotum. This defect can be either congenital or acquired due to various factors such as excess skin or tissue damage caused by trauma, infection, or other conditions. The procedure involves excising the area of the defect and closing it, with the possibility of using a skin flap if necessary. The provider also irrigates the area, checks for bleeding, and closes all incisions.

2. Official Description

The official description of CPT code 55175 is: ‘Scrotoplasty; simple.’

3. Procedure

1. The patient is appropriately prepped and anesthetized.
2. The provider repairs the simple defect in the scrotum by excising the area of the defect and closing it, using a skin flap if necessary.
3. The provider irrigates the area, checks for bleeding, and closes all incisions.

4. Qualifying circumstances

CPT 55175 is performed when there is a simple defect in the scrotum that requires repair. This defect can be congenital or acquired due to various factors. The procedure is typically performed by a qualified healthcare professional who has the necessary expertise in scrotoplasty. It is important to note that if the defect is complex, CPT code 55180 should be used instead.

5. When to use CPT code 55175

CPT code 55175 should be used when a simple defect in the scrotum needs to be repaired. It is important to accurately document the nature of the defect and ensure that the procedure performed aligns with the description of a simple scrotoplasty. If the defect is complex, CPT code 55180 should be used instead.

6. Documentation requirements

To support a claim for CPT 55175, the healthcare professional must document the following information:

• Nature of the scrotal defect and the need for repair
• Details of the procedure performed, including excision, closure, and the use of a skin flap if applicable
• 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 55175, ensure that the procedure performed aligns with the description of a simple scrotoplasty. If the defect is complex, CPT code 55180 should be used instead. It is important to accurately document the procedure and any additional services provided. Review the payer’s guidelines for any specific requirements or modifiers that may be necessary for proper billing.

8. Historical information

CPT 55175 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 patient undergoes scrotoplasty to repair a simple defect in the scrotum caused by trauma.
2. A congenital scrotal defect is repaired through scrotoplasty in a newborn baby.
3. A patient with an acquired scrotal defect due to infection undergoes scrotoplasty for repair.
4. A scrotal defect caused by excess skin is repaired through scrotoplasty in an adult patient.
5. A patient with a scrotal defect resulting from a previous surgery undergoes scrotoplasty for repair.
6. A provider performs scrotoplasty to repair a simple defect in the scrotum caused by a medical condition.
7. A patient with a scrotal defect due to trauma undergoes scrotoplasty for repair.
8. A congenital scrotal defect is repaired through scrotoplasty in an adolescent patient.
9. A patient with an acquired scrotal defect due to a previous infection undergoes scrotoplasty for repair.
10. A scrotal defect caused by excess tissue is repaired through scrotoplasty in an elderly patient.