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The CPT® Code 54620 refers to the fixation of the contralateral testis as a separate procedure. This procedure is typically indicated in cases of testicular torsion, a medical condition characterized by the twisting of the spermatic cord, which disrupts the blood supply to the affected testicle. The surgical 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 incision is made down to the dartos muscle, which is a layer of tissue in the scrotum. Once the testis is identified, the surgeon carefully opens the layers of the tunica albuginea, the protective covering of the testis, to expose the testis itself. The testis is then inspected and manipulated gently to relieve the torsion. After addressing the affected testis, the contralateral testis is examined for any abnormalities. If the contralateral testis is found to be normal, it is fixed in place to prevent future torsion. This is achieved by everting the tunica vaginalis, which creates contact between the tunica albuginea and the dartos muscle, positioning the testis in an extravaginal position. The fixation is secured using two to three sutures to anchor the peritesticular tissue to the dartos muscle. Following the fixation, the viability of the wrapped testis is re-evaluated, with a pink or dusty rose coloration indicating adequate blood flow. If the testis is viable, it is fixed similarly to the contralateral testis. The procedure concludes with the closure of the dartos layer and the skin. It is important to note that CPT® Code 54620 is specifically used for the fixation of the contralateral testis when performed as a separate procedure, distinct from the reduction of torsion of the testis, which is coded under CPT® Code 54600.
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The procedure associated with CPT® Code 54620 is indicated in the following scenarios:
The procedure for fixation of the contralateral testis involves several critical steps:
Post-procedure care involves monitoring the patient for any signs of complications, ensuring that the testis remains viable, and managing pain as necessary. Patients may be advised on activity restrictions to promote healing and prevent recurrence of torsion. Follow-up appointments are typically scheduled to assess recovery and the condition of both testes.
| Short Descr | SUSPENSION OF TESTIS | Medium Descr | FIXATION CONTRALATERAL TESTIS SEPARATE PROCEDURE | Long Descr | Fixation of contralateral testis (separate procedure) | 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) | 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). | 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. | CR | Catastrophe/disaster related | 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) | 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 |
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| Pre-1990 | Added | Code added. |
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