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Official Description

Excision of extraparenchymal lesion of testis

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

The procedure described by CPT® Code 54512 involves the excision of an extraparenchymal lesion of the testis. An extraparenchymal lesion refers to a growth or abnormality that is situated beneath the tunica vaginalis, which is the membranous covering of the testis, and within the tunica albuginea, the fibrous capsule surrounding the testis. This type of lesion may include benign conditions such as fibromas, calcified pseudotumors, adenomatoid tumors, or lesions associated with testicular appendages. The excision is typically performed to remove these benign lesions, which may cause discomfort or other complications if left untreated. The surgical approach involves exploring the scrotum through a groin incision, allowing for direct access to the affected area. Careful dissection is necessary to protect surrounding structures, including the ilioinguinal nerve, while mobilizing the spermatic cord. The procedure includes steps to ensure the integrity of the testis and to confirm the benign nature of the lesion through biopsies prior to excision. This meticulous approach aims to achieve successful removal of the lesion while preserving testicular function and minimizing postoperative complications.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

The excision of an extraparenchymal lesion of the testis, as described by CPT® Code 54512, is indicated for the following conditions:

  • Benign Lesions Lesions such as fibromas, calcified pseudotumors, adenomatoid tumors, or testicular appendages that may require surgical intervention due to symptoms or potential complications.

2. Procedure

The procedure for excising an extraparenchymal lesion of the testis involves several critical steps to ensure successful removal while maintaining the integrity of the surrounding structures.

  • Step 1: Incision and Exploration The surgical process begins with a groin incision to explore the scrotum. This approach provides access to the testis while minimizing trauma to surrounding tissues.
  • Step 2: Opening the External Oblique Fascia Once the incision is made, the external oblique fascia is carefully opened. During this step, it is crucial to protect the ilioinguinal nerve to prevent postoperative complications such as pain or sensory loss.
  • Step 3: Mobilization of the Spermatic Cord The spermatic cord is then mobilized, and a tourniquet is placed around it to control blood flow during the procedure. This step is essential for minimizing bleeding and ensuring a clear surgical field.
  • Step 4: Delivery of the Testis The testicle is delivered through the incision while remaining attached to the spermatic cord. This allows for direct visualization and access to the lesion.
  • Step 5: Incision of the Tunica Vaginalis The tunica vaginalis, the protective layer surrounding the testis, is incised to allow inspection of the testis and epididymis. This step is critical for identifying the lesion that requires excision.
  • Step 6: Identification and Biopsy of the Lesion The lesion is identified during the inspection, and biopsies are obtained prior to excision. These biopsies are sent for a separately reportable frozen section analysis to confirm the benign nature of the lesion.
  • Step 7: Excision of the Lesion After confirming that the lesion is benign, the lesion is excised. This step involves careful dissection to ensure complete removal while preserving surrounding healthy tissue.
  • Step 8: Replacement and Closure Following the excision, the testis is replaced back into the scrotal sac. The tourniquet around the spermatic cord is then removed, and the surgical wound is irrigated to reduce the risk of infection. Finally, the wound is closed in layers to promote proper healing.

3. Post-Procedure

Post-procedure care following the excision of an extraparenchymal lesion of the testis typically includes monitoring for any signs of complications such as infection, bleeding, or pain. Patients may be advised to rest and avoid strenuous activities for a specified period to facilitate healing. Follow-up appointments are essential to assess the surgical site and to review the results of the frozen section biopsy. Any additional care instructions or restrictions will be provided based on the individual patient's condition and the surgeon's recommendations.

Short Descr EXCISE LESION TESTIS
Medium Descr EXC XTRPARENCHYMAL LESION TESTIS
Long Descr Excision of extraparenchymal lesion of testis
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) 1 - 150% payment adjustment for bilateral procedures applies.
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) 1 - Co-surgeons could be paid, though supporting documentation is required...
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
22 Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service.
50 Bilateral procedure: unless otherwise identified in the listings, bilateral procedures that are performed at the same session, should be identified by adding modifier 50 to the appropriate 5 digit code. note: this modifier should not be appended to designated "add-on" codes (see appendix d).
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).
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.
62 Two surgeons: when 2 surgeons work together as primary surgeons performing distinct part(s) of a procedure, each surgeon should report his/her distinct operative work by adding modifier 62 to the procedure code and any associated add-on code(s) for that procedure as long as both surgeons continue to work together as primary surgeons. each surgeon should report the co-surgery once using the same procedure code. if additional procedure(s) (including add-on procedure(s) are performed during the same surgical session, separate code(s) may also be reported with modifier 62 added. note: if a co-surgeon acts as an assistant in the performance of additional procedure(s), other than those reported with the modifier 62, during the same surgical session, those services may be reported using separate procedure code(s) with modifier 80 or modifier 82 added, as appropriate.
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.)
80 Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s).
AS Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery
GC This service has been performed in part by a resident under the direction of a teaching physician
LT Left side (used to identify procedures performed on the left side of the body)
RT Right side (used to identify procedures performed on the right side of the body)
SG Ambulatory surgical center (asc) facility service
XS Separate structure, a service that is distinct because it was performed on a separate organ/structure
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
2001-01-01 Added First appearance in code book in 2001.
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