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Urology Reimbursement: Coding for MESA, TESA

Posted on 17. Dec, 2009 by .

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Question: Could you please give me the most current coding guidelines for the MESA and TESA procedures? The last I was aware, we were to use unlisted procedure codes. Is that still correct?

Answer: You should still use unlisted procedure codes to report microsurgical epididymal sperm aspiration (MESA) and testicular sperm aspiration (TESA, sometimes called TESE for testicular sperm extraction).

There are no Category I procedure codes for these procedures. For MESA, however, there is an S code: S4028 (Microsurgical epididymal sperm aspiration).

Bad news: Unfortunately, not all payers, including Medicare, will pay for S4028. S codes, found in the HCPCS manual, are temporary national codes for which Medicare will not reimburse you. You may typically report S codes to some private payers and Medicaid, but doublecheck the rules for your particular state and payer.

For payers that do not recognize S codes, you should report the unlisted procedure code,…

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