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Testicular torsion is a medical emergency characterized by the twisting of the spermatic cord, which disrupts the blood supply to the affected testicle. This condition can lead to severe pain and potential loss of the testis if not addressed promptly. The surgical procedure described by CPT® Code 54600 involves the reduction of this torsion, which may be accompanied by the fixation of the contralateral testis to prevent future occurrences. The approach to the testis can vary, utilizing either a single vertical midline incision in the scrotum, two separate hemiscrotal incisions, or a transverse incision, allowing access to the affected area. During the procedure, the layers of the tunica albuginea are carefully opened to expose the testis, which is then inspected and manipulated to relieve the torsion. Following the reduction, the testis may be wrapped in warm, moist gauze while the contralateral testis is examined for any abnormalities. If the contralateral testis is found to be normal, it may be fixed in place to prevent future torsion. This procedure is critical for preserving testicular viability and ensuring proper blood flow, which is indicated by the testis returning to a healthy color post-reduction. The closure of the surgical site involves suturing the dartos layer and the skin, completing the procedure.
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The procedure described by CPT® Code 54600 is indicated for the following conditions:
The surgical procedure for the reduction of torsion of the testis involves several critical steps:
Post-procedure care involves monitoring the patient for any signs of complications, such as infection or recurrence of torsion. The patient may require pain management and should be advised on activity restrictions during the recovery period. Follow-up appointments are essential to ensure proper healing and to assess the viability of the testis. Any concerns regarding swelling, pain, or changes in the appearance of the scrotum should be reported to the healthcare provider promptly.
| Short Descr | REDUCE TESTIS TORSION | Medium Descr | RDCTJ TORSION TSTIS W/WO FIXJ CLAT TESTIS | Long Descr | Reduction of torsion of testis, surgical, with or without fixation of contralateral 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) | 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) | P1G - Major procedure - Other | MUE | 1 | CCS Clinical Classification | 118 - Other OR therapeutic procedures, male genital |
| 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). | 52 | Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well-being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use). | 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. | 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) |
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