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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. This plaque develops in the spongy erectile tissue, which can be located on either the upper or lower side of the penis. The presence of this plaque can lead to a curvature of the penis during an erection, causing discomfort and potential difficulties with sexual function. The injection procedure for Peyronie's disease, identified by CPT® Code 54205, involves a more invasive approach than other treatment options. In this procedure, the physician performs a surgical exposure of the plaque, which allows for direct access to the affected area. Following the surgical exposure, a drug is injected into the plaque at multiple sites. This method aims to break down the scar tissue and promote the regeneration of normal tissue, thereby addressing the curvature and restoring function. Commonly used medications for this injection include collagenase, calcium channel blockers such as verapamil, and interferons, which are administered directly into the plaque to enhance treatment efficacy.
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The injection procedure for Peyronie's disease with surgical exposure of plaque is indicated for patients who exhibit the following conditions:
The procedure for CPT® Code 54205 involves several critical steps to ensure effective treatment of Peyronie's disease:
After the injection procedure for Peyronie's disease, patients may require specific post-procedure care to ensure optimal recovery and outcomes. It is essential for patients to follow their physician's instructions regarding activity restrictions, wound care, and any prescribed medications. Patients may experience some discomfort or swelling at the injection site, which is typically managed with over-the-counter pain relief. Follow-up appointments may be scheduled to monitor healing and assess the effectiveness of the treatment. Additionally, patients should be informed about potential side effects and the importance of reporting any unusual symptoms to their healthcare provider.
| Short Descr | NJX PX PEYRONIE DS EXPS PLAQ | Medium Descr | INJECTION PX PEYRONIE DS W/SURG EXPOSURE PLAQUE | Long Descr | Injection procedure for Peyronie disease; with surgical exposure of plaque | Status Code | Active Code | Global Days | 090 - Major Surgery | 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) | 2 - Payment restriction for assistants at surgery does not apply 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 | Hospital Part B services paid through a comprehensive APC | ASC Payment Indicator | Surgical procedure on ASC list in CY 2007; payment based on OPPS relative payment weight. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P5E - Ambulatory procedures - other | MUE | 1 | CCS Clinical Classification | 118 - Other OR therapeutic procedures, male genital |
| 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). | 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. |
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| 2025-01-01 | Changed | Short and Medium Descriptions changed. |
| Pre-1990 | Added | Code added. |
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