Hello. Today we're going to talk about
the Male Genital System. The first thing
I want to do and the only screenshot I'm
going to show from the code book is to
look at some of the annotations I have
made and to just make the point I think
is important when you've got several
parts of the system, in this case, the
Male Genital System. Several parts of the
system on the same page that you make a
point of writing beside each procedure
which part of the body you're talking
about. So under Epididymis, you see Incision-Epididymis
Excision- Epididymis, over here
Tunica vaginalis (which is the membrane
covering the testes-- Incision,
Excision, Repair, each time making the
point of writing beside them what it is.
Then the Scrotum: Incision, Scrotum-
Excision, Scrotum; the next page it
continues up at the top. Notice the very
first one is Scrotum-Repair but then you
go into the Vas Deferens and then how
those break apart. Spermatic cord
down at the bottom; Laparoscopy, Seminal
Vesicles. just so you make sure and
identify each one because it's easy when
there's so many on a page to get those
confused. That's all I wanted to show you
in the code book for this lecture.
Everything else will be the PowerPoint
slides and I'm going to be highlighting
the Male Genital System that are covered
in the codebook and only a few things
are covered in this part of the body in
the textbook. One is the removal of
lesions because I think that's fairly
common. I've identified a few here and
note that the code selection is
determined by the method of removal
whether it be cryosurgery or however
they do it. It's important when you're
reading your report, your operative
report or your doctor's report, that you
note how it's worded because if it is a
subcutaneous
lesion, for example, that's going to
be in the Integumentary System instead
of in the Genital System. I have that
same point made here. You just have to
read your operative report to see where
the doctor is removing the lesions and
if it's considered a subcutaneous lesion,
that is going to be in the Integumentary
System. A couple of procedures are talked
about in the textbook. One is a
prostatectomy and it is differentiated by
its approach, whether it be transurethral
which is the most common, also
referred to as a TURP in which a scope is
inserted through the urethra. "Trans" means
"through" or "within" so (with a) transurethral approach
the doctor is getting to the prostate
through the urethra, using the scope.
Once the surgeon gets into the prostate they
remove tissue, small amounts at a time,
through the scope. A retropubic (approach) is an
incision in the front wall of the abdomen
to reach the prostate. There is also a
laparascopic retropubic code, so don't
think that it when it says incision,
don't think that it's just an "open" approach; you
could also do it laparoscopically.
Perineal approach is an incision between the back
of the scrotum and the anus, the
perineal area. So that's how you would
differentiate those codes. I wanted to
put this in here. It's not mentioned in
the textbook but it's fairly common and
specifically if you are working in a
urology or pediatrics practice.
Hypospadias is a birth defect that
affects male babies and the urethra is
opening on the underside of the penis
instead of at the tip. This is pretty common,
easily treatable and the surgeons
correct that. My nephew was
born with it and I think he was about 18
months old when they went in and did
that surgery. The last thing I want
to mention in the code book are the
codes for intersex surgery. As this
becomes more socially acceptable we may
see it more frequently and I just wanted
you to be aware that these codes are in
the Male Genital System section of the
CPT code book. So now let's look at some of
the exercises from your textbook. The
first one refers to a subcutaneous
abscess on the penis. Remember that
subcutaneous, you're going to go back to
the Integumentary
System. It will give you this code. The
next exercise has to do with the
vasectomy. There's the answers for that
one. Left inguinal orchiectomy or
removal of testes is your Operative
Report #2. There is the path and
the code. Notice that your modifier (Left)
is included because the testes are
bilateral body parts. Removal of the condylomas
which are genital warts, with the use of
cryosurgery. There's the code. An incision
into an abscess of the scrotal wall.
There are the answers. Laparoscopic
retropubic radical prostatectomy. There is
the code. Removal of an inflatable penile
prosthesis and there's the code. I have
not worked very much in trauma but I
know that it is not uncommon for
gentlemen to use a penile prosthesis
after there's been a traumatic
amputation of the penis. Here's the
hypospadias repair that I just wanted to
talk about a little bit because it is
fairly common.
You would be dependent upon the
operative report to help you know how to
code this. If you've any questions about
the Male Genital System, please post them
in the Discussion Board along with the
index path you use to find the code and
I will try to answer them for you. Thank
you so much and have a good day.