© Copyright 2025 American Medical Association. All rights reserved.
Peyronie's disease is a condition that affects the penis, characterized by the formation of a hard, fibrous layer of scar tissue, known as plaque, beneath the skin in the spongy erectile tissue. This plaque can lead to a curvature of the penis during an erection, which may cause discomfort and difficulties during sexual intercourse. The injection procedure described by CPT® Code 54200 is a minimally invasive treatment option aimed at addressing this condition. During the procedure, a physician administers an injectable medication that targets the scar tissue, promoting its breakdown and facilitating the regeneration of normal tissue. Commonly used medications for this injection include collagenase, which specifically breaks down collagen in the plaque, as well as calcium channel blockers like verapamil and interferons, which may help in reducing the size of the plaque. The injections are typically performed at multiple sites on the affected side of the penis, allowing for a more effective treatment of the curvature caused by Peyronie's disease. This procedure can be performed with or without surgical exposure of the plaque, depending on the specific circumstances and the approach taken by the physician.
© Copyright 2025 Coding Ahead. All rights reserved.
The injection procedure for Peyronie's disease, as described by CPT® Code 54200, is indicated for patients who exhibit the following conditions:
The injection procedure for Peyronie's disease involves several key steps to ensure effective treatment:
Following the injection procedure for Peyronie's disease, patients may experience some localized swelling, bruising, or discomfort at the injection sites. It is important for patients to follow any post-procedure care instructions provided by their physician, which may include avoiding sexual activity for a specified period and monitoring for any adverse reactions. Regular follow-up appointments may be scheduled to assess the effectiveness of the treatment and to determine if additional injections or alternative therapies are necessary. The overall recovery time can vary based on individual patient factors and the extent of the condition being treated.
Short Descr | INJECTION PX PEYRONIE DS | Medium Descr | INJECTION PROCEDURE FOR PEYRONIE DISEASE | Long Descr | Injection procedure for Peyronie disease; | Status Code | Active Code | Global Days | 010 - Minor Procedure | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 2 - Standard payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 1 - Statutory payment restriction for assistants at surgery applies to this procedure... | Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Procedure or Service, Multiple Reduction Applies | ASC Payment Indicator | Office-based surgical procedure added to ASC list in CY 2008 or later with MPFS nonfacility PE RVUs; payment based on MPFS nonfacility PE RVUs. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P6C - Minor procedures - other (Medicare fee schedule) | MUE | 1 | CCS Clinical Classification | 117 - Other non-OR therapeutic procedures, male genital |
58 | Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78. | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | 51 | Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 76 | Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | 78 | Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.) | 79 | Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.) | AQ | Physician providing a service in an unlisted health professional shortage area (hpsa) | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | CR | Catastrophe/disaster related | GA | Waiver of liability statement issued as required by payer policy, individual case | GC | This service has been performed in part by a resident under the direction of a teaching physician | JZ | Zero drug amount discarded/not administered to any patient | XE | Separate encounter, a service that is distinct because it occurred during a separate encounter | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
Date
|
Action
|
Notes
|
---|---|---|
2025-01-01 | Changed | Short and Medium Descriptions changed. |
2010-01-01 | Changed | Code description changed. |
Pre-1990 | Added | Code added. |
Get instant expert-level medical coding assistance.