Commercial Insurance Coverage for Inflatable Penile Prosthesis at a Tertiary Care Center

Urology Practice
John M MastersonRanjith Ramasamy

Abstract

Inflatable penile prosthesis has become an important treatment modality for men with erectile dysfunction that is refractory to medication. Despite high levels of patient satisfaction following inflatable penile prosthesis placement and inflatable penile prosthesis coverage by Medicare, coverage by commercial insurance providers is unknown. The purpose of this study was to determine the coverage of inflatable penile prosthesis by commercial insurance providers. Following institutional review board approval all men with erectile dysfunction interested in obtaining inflatable penile prosthesis at our tertiary care center between January 2016 and December 2017 were evaluated. We reviewed billing records for CPT code 54405 during the study period to evaluate the insurance provider for all men who received an inflatable penile prosthesis. We also reviewed a manually maintained record of excluded or denied inflatable penile prosthesis claims for men who desired inflatable penile prosthesis but could not obtain it. Through medical record review we recorded the etiology of erectile dysfunction and the specific type of insurance policy for each man. Medicare is the most common insurer for inflatable penile prosthesis, insuring 87 of 220...Continue Reading

References

Apr 1, 1973·The Journal of Urology·P A MoralesE D Whitehead
May 17, 2014·International Journal of Impotence Research·R L SegalA L Burnett
Mar 13, 2015·Korean journal of urology·Brian Le, Arthur L Burnett
Dec 15, 2017·Translational Andrology and Urology·Katherine M RodriguezTariq S Hakky

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Citations

Apr 15, 2020·International Journal of Impotence Research·John M MastersonRanjith Ramasamy
Jan 4, 2020·International Journal of Impotence Research·Kevin KrughoffMartin S Gross
Jul 13, 2021·The Journal of Sexual Medicine·John T BarnardFaysal A Yafi

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