Each year the AMA (American Medical Association) publishes new, revised, and deleted codes to the CTP code set, including logic and rationale related to the updates. In this blog, we will discuss the 2022 CPT changes regarding hypospadias repair and ultrasound-guided focal ablation of the prostate.
Hypospadias Repair
For FY 2022, there were several editorial revisions to hypospadias repair codes. “(s)” has been added to the word “complication” to indicate that there may be more than one complication when reporting codes 54340, 54344 and 54348. Code 54348 now includes the term “when performed” as it relates to urinary diversion, and the phrase “repair of hypospadias cripple” was replaced with “revision of hypospadias repair” in 54352 to more accurately describe the procedure performed. An exclusionary parenthetical note has also been added to 54352.
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CPT 2021 |
CPT 2022 |
| 54340 Repair of hypospadias complications (ie, fistula, stricture, diverticula); by closure, incision, or excision, simple | 54340 Repair of hypospadias complication(s) (ie, fistula, stricture, diverticula); by closure, incision or excision, simple |
| 54344 Repair of hypospadias complications (ie, fistula, stricture, diverticula); requiring mobilization of skin flaps and urethroplasty with flap or patch graft | 54344 Repair of hypospadias complication(s) (ie, fistula, stricture, diverticula); requiring mobilization of skin flaps and urethroplasty with flap or patch graft |
| 54348 Repair of hypospadias complications (ie, fistula, stricture, diverticula); requiring extensive dissection and urethroplasty with flap, patch or tubed graft (includes urinary diversion) | 54348 Repair of hypospadias complication(s) (ie, fistula, stricture, diverticula); requiring extensive dissection and urethroplasty with flap, patch or tubed graft (including urinary diversion, when performed) |
| 54352 Repair of hypospadias cripple requiring extensive dissection and excision of previously constructed structures including re-release of chordee and reconstruction of urethra and penis by use of local skin as grafts and island flaps and skin brought in as flaps or grafts | 54352 Revision of prior hypospadias repair requiring extensive dissection and excision of previously constructed structures including re-release of chordee and reconstruction of urethra and penis by use of local skin as grafts and island flaps and skin brought in as flaps or grafts
(Do not report 54352 in conjunction with 15275, 15574, 15740, 53235, 53410, 54336, 54340, 54344, 54348, 54360) |
New Category III Code: Ultrasound-Guided Focal Laser Ablation of Prostate
Prior to 2022, a code for ultrasound-guided or ultrasound-fusion-guided focal laser ablation of malignant prostate tissue did not exist in the CPT code set. New Category III Code 0655T has been established to report this procedure. An exclusionary parenthetical note has also been included to clarify which procedures should not be reported in conjunction with 0655T.
- 0655T Transperineal focal laser ablation of malignant prostate tissue, including transrectal imaging guidance, with MR-fused images or other enhanced ultrasound imaging
(Do no report 0655T is conjunction with 52000, 76376, 76377, 76872, 76940, 76942, 76998)
Focal laser ablation (also known as photothermal therapy, laser interstitial therapy, or laser interstitial photocoagulation) destroys tissue via a focused beam of electromagnetic radiation discharged from a laser fiber. The temperature of the tissue at the fiber’s tip is increased, resulting in coagulative necrosis.
Coding Tip
To avoid confusion between two similar procedures, be sure to understand the difference between 0655T and 55880, Ablation of malignant prostate tissue, transrectal, with high intensity-focused ultrasound, including ultrasound guidance. 0655T and 55880 are both performed to treat malignant prostate tissue via coagulative necrosis. However, there are several differences as illustrated in the table below:
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0655T Transperineal focal laser ablation of malignant prostate tissue, including transrectal imaging guidance, with MR-fused images or other enhanced ultrasound imaging |
55880 Ablation of malignant prostate tissue, transrectal, with high intensity-focused ultrasound, including imaging guidance
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| Transperineal approach, transrectal imaging guidance | Transrectal approach |
| Coagulation necrosis is performed via focal laser ablation (FLA) | Coagulation necrosis is performed via high-intensity focused ultrasound (HIFU) ablation |
| Laser light delivered through the fiber creates heat | Ultrasound transducers create heat via timed bursts |
Additional Information
Additional information regarding hypospadias repair and ablation of malignant prostate tissue can be found below:
- American Medical Association (AMA) CPT 2022 Professional Edition (includes rules and guidelines from the AMA’s CPT Editorial Panel)
- AHA Coding Clinic for HCPCS- Second Quarter 2021 Pages: 5-6 “Category III codes effective July 1, 2021”
- AMA CPT Assistant, September 2021 Page: 11 “Prostate malignancy ablation”
- AHA Coding Clinic for HCPCS- First Quarter 2022 Page: 11-13 “Surgical removal of tissue by destruction”
