Summary & Overview
CPT 55120: Removal of Foreign Body from Scrotum/Testicle
CPT code 55120 denotes surgical removal of a foreign body from the scrotum or testicles after traumatic injury. It is a focused, often urgent operative procedure intended to prevent ongoing damage to the scrotal contents and to evaluate and protect testicular function. Nationally, this code is relevant to trauma, urology, and emergency surgical services and has implications for facility utilization, operative resource allocation, and episode-of-care coding.
Key payers commonly involved in coverage and claims adjudication include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical intent and typical settings, plus benchmarking and coding guidance relevant to payers named above. The publication provides a national perspective on how this procedure is classified, typical sites of service (hospital operating rooms, ambulatory surgery centers, and emergency department procedure areas), and the clinical context that justifies use of the code.
Content covers expected documentation elements, common billing considerations, and how this code fits within broader surgical and trauma care episodes. Data-specific benchmarks, payer-specific reimbursement rates, and other quantitative metrics: Data not available in the input.
Billing Code Overview
CPT code 55120 describes the surgical removal of a foreign body from the scrotum, the pouch that contains the testes, or testicles, typically performed after a traumatic injury to prevent further damage to the scrotal contents. The procedure involves exploration and extraction of non-native material from the scrotal sac and may include measures to assess and preserve testicular viability.
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Service type: Surgical foreign body removal from the scrotum following trauma
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Typical site of service: Hospital operating room, ambulatory surgery center, or emergency department procedure area
Clinical & Coding Specifications
Clinical Context
A 28-year-old male presents to the emergency department after a workplace accident in which a sharp metal fragment penetrated the scrotum. The patient reports acute localized pain, visible laceration of the scrotal skin, and possible palpable foreign material. Physical exam demonstrates a superficial puncture wound to the hemiscrotum with suspected retained foreign body and localized swelling but preserved testicular position and reflexes. Focused scrotal ultrasound is performed to localize the foreign body and to assess testicular integrity. The urology surgeon performs a brief procedure in the operating room or procedure suite to explore the scrotal wound, irrigate, remove the foreign object, achieve hemostasis, and close the wound. Specimens are not expected to require separate pathology. The procedure is coded as 55120 (removal of foreign body from scrotum) and is typically billed from an inpatient or outpatient hospital operating room, ambulatory surgery center, or emergency department procedure area depending on clinical acuity and anesthesia needs. Post-procedure care includes wound checks, antibiotics as indicated, tetanus prophylaxis if needed, and return precautions for signs of infection or testicular compromise.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when the procedure requires substantially greater work than typical (extensive debridement, prolonged exploration) with documentation of reasons for increased effort. |