CPT Code 54500: Overview

Code: 54500
Description: Biopsy of testis, needle
Context: This code is used for a needle biopsy of the testis. It’s a diagnostic procedure performed to obtain a small tissue sample from the testis, typically for the evaluation of conditions like infertility or to diagnose testicular masses or tumors.

Guidelines for Proper Use

  • Specific Use for Testicular Needle Biopsy: Apply 54500 for procedures where a needle biopsy of the testis is performed. This procedure is primarily used to diagnose abnormalities in testicular tissue.
  • Documentation of Procedure: Ensure healthcare providers’ documentation includes details of the biopsy, such as the indication for the procedure, how it was performed, and any findings or complications.
  • Exclusion of Other Biopsy Methods: Do not use 54500 if a different type of biopsy method is used (e.g., open biopsy). There are specific codes for other biopsy techniques.
  • Applicability in Various Clinical Settings: This code can be used for testicular needle biopsies conducted in hospitals, outpatient surgical centers, or urology clinics.
  • Compliance with Urological Procedure Protocols: Use 54500 in accordance with standard urological procedure guidelines and protocols, as well as payer-specific rules.

Common Misuses of 54500

  • Using for Other Biopsy Methods: Misuse occurs if 54500 is applied to testicular biopsies performed using methods other than needle biopsy.
  • Inadequate Documentation of Procedure: Not providing sufficient detail about the needle biopsy, such as the technique used or the rationale behind the procedure, can lead to misuse of this code.
  • Bundling with Other Procedures: If additional procedures, such as an ultrasound or more extensive surgical intervention, are performed during the same session, they should be billed separately and not included under 54500.
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