How To Use CPT Code 55870

CPT 55870 describes the procedure of electroejaculation, which involves using electrical current to stimulate ejaculation and collect a semen sample. This article will cover the description, official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 55870?

CPT 55870 can be used to describe the procedure of electroejaculation, which is performed to collect a semen sample for intrauterine insemination or artificial insemination. This code is used when a healthcare provider uses electrical current to stimulate ejaculation by inserting an electrode probe into the rectum and adjacent to the prostate gland. The electrical stimulation causes contraction of pelvic muscles and ejaculation, allowing the provider to collect the semen sample for further analysis and treatment of infertility.

2. Official Description

The official description of CPT code 55870 is: ‘Electroejaculation: Electrical stimulation of the prostate gland via the rectum to promote ejaculation for the purpose of collecting a semen sample.’

3. Procedure

1. The patient is appropriately prepped and anesthetized.
2. The healthcare provider inserts an electrode probe into the rectum and adjacent to the prostate gland.
3. A minor electrical current is passed through the probe to stimulate the nearby nerves and reproductive organs.
4. This stimulation results in the contraction of pelvic muscles and ejaculation.
5. The healthcare provider collects the semen sample and sends it to a laboratory for analysis.

4. Qualifying circumstances

CPT 55870 is performed on patients who require a semen sample for intrauterine insemination or artificial insemination. It is typically used in cases of infertility where the patient is unable to produce a semen sample through natural means. The procedure involves electrical stimulation of the prostate gland via the rectum, so patients must be appropriately prepped and anesthetized to ensure their comfort and safety during the procedure.

5. When to use CPT code 55870

CPT code 55870 should be used when a healthcare provider performs electroejaculation to collect a semen sample for intrauterine insemination or artificial insemination. It is important to note that this code specifically refers to the procedure of electroejaculation and should not be used for other methods of semen collection or for different purposes.

6. Documentation requirements

To support a claim for CPT 55870, the healthcare provider must document the following information:

• Reason for performing electroejaculation and the need for a semen sample
• Details of the procedure, including the use of electrical stimulation and the insertion of the electrode probe
• Date and duration of the procedure
• Any complications or adverse reactions experienced by the patient
• Documentation of the collected semen sample and its handling
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT 55870, ensure that the procedure meets the criteria for electroejaculation and that the appropriate documentation is provided. It is important to note that CPT 55870 should not be reported with other codes unless there are additional services or procedures performed during the same encounter. It is also important to follow any specific billing guidelines provided by insurance companies or payers to ensure accurate reimbursement for the procedure.

8. Historical information

CPT 55870 was added to the Current Procedural Terminology system on January 1, 1992. There have been no updates or changes to the code since its addition.

9. Examples

1. A healthcare provider performs electroejaculation on a patient with infertility issues to collect a semen sample for intrauterine insemination.
2. During the electroejaculation procedure, the healthcare provider uses electrical stimulation to promote ejaculation and collect a semen sample for artificial insemination.
3. A patient undergoes electroejaculation as part of their fertility treatment plan, with the collected semen sample being used for further analysis and treatment.
4. Electroejaculation is performed on a patient who is unable to produce a semen sample naturally, allowing for the collection of a sample for intrauterine insemination.
5. A healthcare provider uses electroejaculation to collect a semen sample from a patient with infertility issues, which will be used for artificial insemination.
6. During the electroejaculation procedure, the healthcare provider stimulates the prostate gland via the rectum to promote ejaculation and collect a semen sample for further analysis and treatment.
7. A patient undergoes electroejaculation to collect a semen sample for intrauterine insemination, as part of their fertility treatment plan.
8. Electroejaculation is performed on a patient who requires a semen sample for artificial insemination, as they are unable to produce a sample naturally.
9. A healthcare provider uses electrical stimulation to promote ejaculation and collect a semen sample from a patient, which will be used for intrauterine insemination.
10. During the electroejaculation procedure, the healthcare provider collects a semen sample from a patient for further analysis and treatment of their infertility.