AHA Coding Clinic® for HCPCS - 2023 Quarter 4; Ask the Editor

Excision of Spermatic Cord Lipoma with Inguinal Hernia Repair

An adult patient presented for left inguinal hernia repair. The patient was taken to the operating room where a left groin incision was made. Dissection was carried down through Scarpa’s fascia to the external oblique fascia, which was opened. The spermatic cord and its contents were mobilized up to the internal ring, revealing a direct defect. No indirect hernia sac was found. A moderate sized cord lipoma was dissected away from the cord structures, ligated and excised. The inguinal floor was opened; the preperitoneal space bluntly developed. Mesh was secured to the pubic tubercle and tacked to the rectus. A slit was made in the mesh and the two cut edges encircled around the spermatic cord creating a new internal ring. The spermatic cord was then returned to its anatomic position. The wound was closed in layers; Steri-strips and a sterile dressing were placed. The patient was extubated and in stable condition. Can CPT code 55520 -59 be reported for the excision of the spermatic cord lipoma via the same incision as the hernia repair since the hernia repair and lipoma excision are from two different body systems (abdomen and urinary)? ...

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