Modifiers -51 & -59

Hospital consultation codes

Anaphylactic shock

Clarification

In the July/August issue, “CPT code for semen analysis” [page 26] indicated that CPT code 89321 should be used for semen analysis post-vasectomy. This is true as long as the vasectomy and semen analysis were not performed by the same entity (e.g., if a family practice office lab does a semen analysis for a patient who received a vasectomy from a urologist across town). When the two services are performed by the same entity, the more appropriate code to use is 55250, “Vasectomy, unilateral or bilateral (separate procedure), including postoperative semen examination(s).”

Editor’s note: While this department attempts to provide accurate information and useful advice, third-party payers may not accept the coding and documentation recommended. You should refer to the current CPT and ICD-9 manuals and the Documentation Guidelines for Evaluation and Management Services for the most detailed and up-to-date information.