Common problems in Male Infertility and Vasectomy Technology


The code for a vasectomy is 55250. In vasectomy, whether you do it unilateral or bilateral, it includes postoperative semen examinations. This is the code that most urologists use when they perform a vasectomy for sterilization. It has a 90-day global and the semen analysis that you perform should be performed, included in the 55250 until the patient (sows) azoospermia or no sperm within the ejaculate. Now, pre – vasectomy clips are usually not reimbursed separately but some carriers pay a tray charge using the code A4550. There are still a few private carriers out there that will pay the tray charge along with your vasectomy code when performed in the office. Also, use this code – the 55250 – when performing the no scalpel technique vasectomy procedure.

The other technique of doing a vasectomy is percutaneous ligation, that's the 55450, which is not the code that you should be using for a vasectomy for sterilization. Now, you also have an unlisted laparoscopic procedure for the spermatic cord, 55559. And this unlisted code should be used for laparoscopic vasectomy either unilateral or bilateral. Most often, one would use this code, 55559, when you are doing a vasectomy, you have been requested to do a vasectomy for sterilization and you are doing this in conjunction with the surgeon who is doing a laparoscopic hernia repair.

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May 24, 2018
Philip Vassallo
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Margie Scalley Vaught
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Margie Scalley Vaught
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Suppose we're using the unlisted procedure, spermatic cord, 55559, for a laparoscopic vasectomy. The procedure, laparoscopic bilateral inguinal hernia repair by the general surgeon and he's going to bill the 49650-50 and he's going to bill an ICD diagnosis of 550.92. That's bilateral hernia without obstruction or gangrene. And the procedure for the urologist, he's going to do a laparoscopic bilateral vasectomy and he's going to bill the 55559 for the bilateral vasectomy and his diagnosis is going to be V25.2. And the procedure for the urologist, he's going to do a laparoscopic bilateral vasectomy and he's going to bill the 55559 for the bilateral vasectomy and his diagnosis is going to be V25.2. The urologist will benchmark or should benchmark this code, the laparoscopic – the 55559 – with the open vasectomy code, 55250. Now, let's look at another clinical scenario. This is a failed vasectomy. Here we have persistent spermatozoa seen on all semen analyses after the vasectomy. It never becomes azoospermic. And the procedure we're doing is the repeat vasectomy at four months.

We're going to bill the vasectomy code, 55250, and the diagnosis is going to be sterilization vasectomy code, V25.2 and the V25.8 is going to be for a post vasectomy sperm count. And we may even want to add the E-code indicating the etiology of why this happened. And this would be E876.2, suture failure.

 
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