How To Use CPT Code 55400

CPT 55400 describes a procedure known as vasovasostomy, which is used to reverse a vasectomy and restore fertility. 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 55400?

CPT 55400 is a code that represents the vasovasostomy procedure, which is performed to reconnect the tubes (vas deferens) that were previously cut during a vasectomy. This procedure allows for the restoration of fertility by enabling the passage of sperm through the reconnected tubes.

2. Official Description

The official description of CPT code 55400 is: ‘Vasovasostomy, vasovasorrhaphy.’ This code is used to indicate the surgical procedure of reconnecting the vas deferens to restore fertility after a vasectomy. It is important to note that if the procedure is performed bilaterally, modifier 50 should be appended to the code.

3. Procedure

1. The vasovasostomy procedure begins with the administration of anesthesia to ensure the patient’s comfort throughout the surgery.
2. An incision is made over the scrotum to access the vas deferens.
3. The surgeon identifies the vas deferens and isolates the surrounding fluids.
4. The severed ends of the vas deferens are carefully joined together using microsurgical sutures.
5. Precision is crucial in reconnecting the sperm canal edges to achieve a successful outcome.
6. If necessary, a double-layer closure may be performed, with the inner layer stitched first, followed by the outer layer.
7. To confirm the patency of the reconnected tubes, dye may be injected.
8. Once the procedure is completed, the incisions are closed in layers.

4. Qualifying circumstances

CPT 55400 is performed on patients who have previously undergone a vasectomy and now wish to restore their fertility. The procedure is suitable for individuals who desire to reconnect the vas deferens to allow the passage of sperm. It is important to note that the procedure should be performed by a qualified healthcare professional with expertise in vasovasostomy.

5. When to use CPT code 55400

CPT code 55400 should be used when a vasovasostomy procedure is performed to reverse a vasectomy and restore fertility. It is important to ensure that the procedure is accurately documented and meets the specific requirements outlined in the code description.

6. Documentation requirements

To support a claim for CPT 55400, the following documentation is necessary:

• Confirmation of the patient’s previous vasectomy
• Details of the vasovasostomy procedure performed
• Documentation of the use of anesthesia
• Information regarding the closure technique used
• Confirmation of the successful reconnection of the vas deferens
• Any additional relevant information or complications encountered during the procedure

7. Billing guidelines

When billing for CPT 55400, it is important to ensure that the procedure is accurately coded and documented. Modifier 50 should be appended to the code if the procedure is performed bilaterally. Additionally, it is essential to follow any specific billing guidelines provided by the payer to ensure proper reimbursement.

8. Historical information

CPT code 55400 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 who previously underwent a vasectomy desires to restore fertility and undergoes a vasovasostomy procedure.
2. A couple seeks to reverse the effects of a vasectomy and opts for a vasovasostomy to increase their chances of conception.
3. A vasectomy reversal is performed on a patient who wishes to have children after a change in their personal circumstances.
4. A man who had a vasectomy years ago decides to undergo a vasovasostomy to regain the ability to father children.
5. A patient consults with a urologist to explore the possibility of reversing a vasectomy through a vasovasostomy procedure.
6. A couple undergoes a vasovasostomy procedure as part of their journey to conceive a child.
7. A vasovasostomy is performed on a patient who desires to restore fertility after a previous vasectomy.
8. A man who had a vasectomy earlier in life decides to undergo a vasovasostomy to increase his chances of starting a family.
9. A patient consults with a reproductive specialist to discuss the possibility of a vasovasostomy to reverse a previous vasectomy.
10. A vasovasostomy procedure is performed on a patient who wishes to regain fertility after a vasectomy.