Fixation of contralateral testis cpt code
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During initial examination, manual detorsion may be attempted. This is done by elevating the testis toward the ipsilateral inguinal ring, stabilizing the cranial portion of the spermatic cord, and rotating the testis laterally. If successful, there will be a lengthening of the spermatic cord and immediate relief of pain. Should the first attempt be unsuccessful, a second attempt could be made using medial rotation of the testis. A study of rotational direction found that 46% of torsions (38 of 81 patients) were laterally rotated. [43] In a series of patients undergoing attempted detorsion, testis salvage was higher in those patients that had successful manual detorsion. [44] Regardless of the outcome of manual detorsion, surgical exploration and testicular fixation should be performed prior to the patient being discharged from the hospital. [1] Show Success of manual detorsion can be assessed with the use of Doppler sonography and resolution of symptoms. [45]  Next: Surgical DetorsionSurgical detorsion and subsequent orchiopexy or orchiectomy is the definitive management strategy and should proceed immediately in patients whose clinical findings suggest torsion. The patient and/or caregiver should be counseled on the risk of immediate or delayed testicular loss. Additionally, they should be advised that the impact of torsion on later fertility, even if testicular salvage occurs, cannot be assured. Extravaginal torsionIn newborns presenting with torsion at birth, the timing of surgical exploration remains controversial, since testicular salvage rates are low and anesthetic risk is increased. Additionally, asynchronous torsion remains uncommon (11.8%). [46, 47] Despite those concerns, most of the literature supports immediate exploration and fixation of the contralateral testis to prevent the potential devastating outcome of asynchronous testis loss. [48, 47] Intravaginal torsionImmediate surgical exploration with detorsion and orchiopexy or orchiectomy is the recommended and accepted management strategy for males presenting with clinical signs of testis torsion. Surgical exploration should not be delayed to obtain confirmatory radiologic studies in patients who present with suggestive clinical signs of torsion. The surgical approach is through a midline longitudinal, or bilateral transverse scrotal incision. On entry into the affected hemi-scrotum, the surgeon should perform immediate detorsion of the affected testis, while noting color, degree of torsion, and anatomy of the tunica vaginalis. After the testis is untwisted, it is wrapped in warm wet gauze. Exploration of the contralateral hemiscrotum and orchiopexy of the unaffected testis is then performed to reduce the risk of asynchronous torsion. The affected testis is re-examined for viability. If blood flow remains questionable, intraoperative Doppler can be utilized, or an incision can be made into the tunica albuginea. If the testis appears viable, orchiopexy is performed. If the decision is made to perform orchiectomy, a prosthesis can be placed at this time, but insertion is often deferred for the nonacute setting. [5] View Media Gallery Previous Medication
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of 8 Tables Back to List Contributor Information and Disclosures Author Ranjiv I Mathews, MD Professor of Urology and Pediatrics, Director of Pediatric Urology, Director of Urology Residency Program, Division of Urology, Department of Surgery, Southern Illinois University School of Medicine Coauthor(s) Roberta Koeppen, MD Resident Physician, Department of Urology, Southern Illinois University School of Medicine Chief Editor Edward David Kim, MD, FACS Professor of Urology, Department of Urology, University of Tennessee Graduate School of Medicine; Consulting Staff, University of Tennessee Medical Center Additional Contributors E Jason Abel, MD Associate Professor of Urologic Oncology, Department of Urology, Associate Professor of Radiology (Affiliate Appointment), Department of Radiology, University of Wisconsin School of Medicine and Public Health; Attending Urologist, William S Middleton Memorial Veterans Hospital Oreoluwa I Ogunyemi, MD Resident Physician, Department of Urology, University of Wisconsin Hospitals and Clinics Madelyn Weiker University of Wisconsin School of Medicine and Public Health Acknowledgements Leslie Tackett McQuiston, MD, FAAP Assistant Professor of Surgery (Urology) Dartmouth Medical School; Staff Pediatric Urologist, Dartmouth-Hitchcock Hospital Leslie Tackett McQuiston, MD, FAAP is a member of the following medical societies: American Academy of Pediatrics and American Urological Association Disclosure: Nothing to disclose. Eugene Minevich, MD Assistant Professor, Department of Surgery, Division of Pediatric Urology, University of Cincinnati Eugene Minevich, MD is a member of the following medical societies: American Academy of Pediatrics, American College of Surgeons, and American Urological Association Disclosure: Nothing to disclose. Raymond Rackley, MD Professor of Surgery, Cleveland Clinic Lerner College of Medicine at Case Western Reserve University; Staff Physician, Center for Pelvic Medicine and Pelvic Reconstruction, Glickman Urological Institute, Cleveland Clinic Foundation Raymond Rackley, MD is a member of the following medical societies: American Urological Association Disclosure: Pfizer, Novartis, Proctor & Gamble, Allergan Honoraria None; Pfizer, Novartis, Proctor & Gamble, Allergan Consulting fee Other Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference What is procedure code 54640?CPT code 54640 (Orchiopexy, inguinal approach, with or without hernia repair) clearly states that hernia repair is included.
What is CPT code 54600?The Current Procedural Terminology (CPT®) code 54600 as maintained by American Medical Association, is a medical procedural code under the range - Repair Procedures on the Testis.
What is surgical fixation of the Testis?An orchiopexy (or-kee-oh-peck-see) is a surgery to move a testicle from your groin (inguinal region) to your scrotum (the pouch of skin behind your penis that typically contains your testes). The procedure permanently fixes your testicle to your scrotum.
What is the CPT code for manual detorsion of testicle?In the above scenario, you are correct, 54600 will cover the detorsion and orchiopexy of both testicles.
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