How To Use CPT Code 55300

CPT 55300 describes a specific procedure involving the vas deferens, which is the duct that carries sperm away from the testicle. 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 55300?

CPT 55300 is a code that represents a procedure performed on the vas deferens, which is the duct responsible for carrying sperm away from the testicle. This procedure involves making an incision in the vas deferens to allow for radiological examination of the vas deferens and its associated structures. It is typically performed to determine if there are any blockages that could impair fertility. The procedure can be performed on one or both sides of the vas deferens.

2. Official Description

The official description of CPT code 55300 is: ‘Vasotomy for vasograms, seminal vesiculograms, or epididymograms, unilateral or bilateral.’ It is important to note that for radiological supervision and interpretation, a different code (74440) should be used. Additionally, if the procedure is combined with a biopsy of the testis, modifier 51 should be used and code 54505 should be reported.

3. Procedure

1. To perform CPT 55300, the provider begins by making an incision in the scrotum, which is the sac that contains the testes.
2. Next, the provider incises the vas deferens, providing access for the injection of contrast media or dye and the performance of radiological studies.
3. Once the radiological studies are complete, the provider irrigates the area, checks for bleeding, removes any instruments, and closes the incision.

4. Qualifying circumstances

CPT 55300 is typically performed on patients who require radiological examination of the vas deferens, seminal vesicles, or epididymis. This procedure is used to assess for blockages or abnormalities that could affect fertility. It is important to note that the procedure can be performed unilaterally (on one side) or bilaterally (on both sides) depending on the specific circumstances of the patient.

5. When to use CPT code 55300

CPT code 55300 should be used when a provider performs a vasotomy for vasograms, seminal vesiculograms, or epididymograms. It is important to ensure that the procedure is performed on the vas deferens and not on other structures. This code should not be used for radiological supervision and interpretation, as a different code (74440) should be used for that purpose.

6. Documentation requirements

To support a claim for CPT 55300, the provider must document the following information:

• Patient’s diagnosis or reason for the procedure
• Details of the procedure performed, including whether it was unilateral or bilateral
• Date of the procedure
• Any additional relevant information, such as complications or findings
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 55300, it is important to ensure that the procedure is performed on the vas deferens and not on other structures. Additionally, if radiological supervision and interpretation are performed, a separate code (74440) should be used. If the procedure is combined with a biopsy of the testis, modifier 51 should be used and code 54505 should be reported. It is important to review the specific guidelines of the payer to ensure accurate billing.

8. Historical information

CPT 55300 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 patient undergoes a vasotomy on both sides of the vas deferens to assess for blockages that could be causing infertility.
2. A radiologist performs a vasogram on a patient to evaluate the vas deferens using contrast media.
3. A provider performs an epididymogram to assess the epididymis for abnormalities using radiological techniques.
4. A patient undergoes a unilateral vasotomy to assess for blockages on one side of the vas deferens.
5. A provider performs a seminal vesiculogram to evaluate the seminal vesicles for any abnormalities using radiological studies.
6. A patient undergoes a bilateral vasotomy to assess for blockages on both sides of the vas deferens.
7. A radiologist performs a vasogram on a patient to evaluate the vas deferens using contrast media.
8. A provider performs an epididymogram to assess the epididymis for abnormalities using radiological techniques.
9. A patient undergoes a unilateral vasotomy to assess for blockages on one side of the vas deferens.
10. A provider performs a seminal vesiculogram to evaluate the seminal vesicles for any abnormalities using radiological studies.