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Laparoscopic orchiectomy is a minimally invasive surgical procedure that involves the removal of one or both testicles through small incisions in the abdomen. The procedure is performed with the patient positioned supine, often in a Trendelenburg position, which helps to facilitate access to the abdominal cavity. Prior to the surgery, a Foley catheter is typically placed transurethrally to assist with bladder management during the procedure. The surgical approach begins with a small U-shaped incision at the umbilicus, allowing for the introduction of a Veress needle into the peritoneal cavity after dissecting through the anterior rectus fascia. This technique creates a pneumoperitoneum, which is essential for providing the necessary working space within the abdomen by insufflating carbon dioxide (CO2). Once the abdominal cavity is inflated, a laparoscope is inserted through the umbilical incision, and additional trocars are placed along the mid-clavicular line to facilitate the use of laparoscopic instruments. The surgeon then identifies and inspects the abdominal organs before proceeding to grasp and dissect the testis from the surrounding tissue. The spermatic cord, which includes the spermatic vessels and vas deferens, is carefully clipped and cut, allowing for the removal of the testis through the ports. After the procedure, the laparoscopic instruments are withdrawn, CO2 is evacuated from the abdominal cavity, and the fascia is closed with sutures, followed by the closure of the skin. This technique is favored for its reduced recovery time and minimized postoperative pain compared to traditional open orchiectomy methods.
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The laparoscopic orchiectomy procedure is indicated for various conditions affecting the testicles. These include:
The laparoscopic orchiectomy procedure involves several key steps, each critical to the successful removal of the testis.
Post-procedure care following laparoscopic orchiectomy typically involves monitoring for any immediate complications, such as bleeding or infection. Patients are usually advised to rest and may be prescribed pain management medications to alleviate discomfort. Recovery time is generally shorter compared to open surgical techniques, with many patients able to resume normal activities within a few days. Follow-up appointments are essential to ensure proper healing and to address any concerns that may arise during the recovery process. Patients should be informed about signs of complications, such as increased pain, swelling, or fever, and instructed to seek medical attention if these occur.
| Short Descr | LAPAROSCOPY ORCHIECTOMY | Medium Descr | LAPAROSCOPY SURGICAL ORCHIECTOMY | Long Descr | Laparoscopy, surgical; orchiectomy | 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) | 2 - Payment restriction for assistants at surgery does not apply 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 |
This is a primary code that can be used with these additional add-on codes.
| 49327 | Addon Code MPFS Status: Active Code APC N ASC N1 Laparoscopy, surgical; with placement of interstitial device(s) for radiation therapy guidance (eg, fiducial markers, dosimeter), intra-abdominal, intrapelvic, and/or retroperitoneum, including imaging guidance, if performed, single or multiple (List separately in addition to code for primary procedure) |
| 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). | 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 | 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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| 2011-01-01 | Changed | Medium description changed. Short description changed. |
| 2000-01-01 | Added | First appearance in code book in 2000. |
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