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The procedure described by CPT® Code 55540 involves the excision of a varicocele or the ligation of spermatic veins specifically for the treatment of a varicocele, which is characterized by the enlargement of veins within the scrotum. This condition can lead to discomfort and potential fertility issues, necessitating surgical intervention. The procedure is performed in conjunction with a hernia repair, indicating that the patient may also have an inguinal hernia that requires correction. The surgical approach typically involves a retroperitoneal incision in the lower abdomen, allowing access to the affected area while minimizing disruption to surrounding tissues. The operation includes several critical steps, such as making a precise skin incision, identifying and isolating the ilioinguinal nerve, and carefully dissecting through muscle layers to reach the retroperitoneal space. Once there, the surgeon can visualize and manipulate the testicular artery and vein, as well as other important vascular structures, to effectively ligate or excise the varicocele. The procedure also incorporates the repair of an inguinal hernia, which is commonly addressed using a mesh patch to reinforce the inguinal canal. Overall, this surgical intervention aims to alleviate symptoms associated with varicocele and restore anatomical integrity in the presence of a hernia.
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The procedure described by CPT® Code 55540 is indicated for the following conditions:
The procedure involves several detailed steps to ensure effective treatment of the varicocele and repair of the hernia:
Post-procedure care typically involves monitoring for any complications such as infection or excessive bleeding. Patients may be advised to avoid strenuous activities for a specified period to promote healing. Follow-up appointments are essential to assess recovery and ensure that the varicocele and hernia repair are healing appropriately. Pain management may be provided as needed, and patients should be instructed on signs of complications that warrant immediate medical attention.
| Short Descr | REVISE HERNIA & SPERM VEINS | Medium Descr | EXC VARICOCELE/LIGATION VEINS W/HERNIA RPR | Long Descr | Excision of varicocele or ligation of spermatic veins for varicocele; with hernia repair | 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 | 86 - Other hernia repair |
| 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. | 82 | Assistant surgeon (when qualified resident surgeon not available): the unavailability of a qualified resident surgeon is a prerequisite for use of modifier 82 appended to the usual procedure code 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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| Pre-1990 | Added | Code added. |
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