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Preputioplasty or prepuce plasty, also known as limited dorsal slit with transverse closure, is a plastic surgical operation on the prepuce or foreskin of the penis, [1] to widen a narrow non-retractile foreskin which cannot comfortably be drawn back off the head of the penis in erection because of a constriction which has not expanded after adolescence.
[5] [7] Occasionally, phimosis may be caused by an underlying condition such as scarring due to balanitis or balanitis xerotica obliterans. [5] This can typically be diagnosed by seeing scarring of the opening of the foreskin. [5] Generally, treatment is not considered necessary unless the foreskin still cannot be retracted by the age of 18. [4]
Dorsal slit is now rare in Western countries as a treatment for phimosis. Standard guidelines suggest conservative approaches first and, should those fail, either circumcision or preputioplasty to both retain the foreskin and relieve the phimosis.
It covers ICD codes 580 to 629. The full chapter can be found on pages 329 to 353 of Volume 1, which contains all (sub)categories of the ICD-9. Volume 2 is an alphabetical index of Volume 1. Both volumes can be downloaded for free from the website of the World Health Organization.
HCPCS includes three levels of codes: Level I consists of the American Medical Association's Current Procedural Terminology (CPT) and is numeric.; Level II codes are alphanumeric and primarily include non-physician services such as ambulance services and prosthetic devices, and represent items and supplies and non-physician services, not covered by CPT-4 codes (Level I).
The CPT code revisions in 2013 were part of a periodic five-year review of codes. Some psychotherapy codes changed numbers, for example 90806 changed to 90834 for individual psychotherapy of a similar duration. Add-on codes were created for the complexity of communication about procedures.
The reduction of the clitoral prepuce tissues usually is a sub-ordinate surgery within a labiaplasty procedure for reducing the labia minora; and occasionally within a vaginoplasty procedure. When these procedures are performed on individuals without their consent, they are considered a form of female genital mutilation.
Another reason for the treatment is to correct a rare complication of a frenulum breve which presents as scars on the frenulum, these scars cause pain and make normal sex very difficult and are caused by the rubbing of the frenulum whilst engaging in sexual activity. These scars only affect those with frenulum breve.