Pediatric Coding Alert

Question: When a pediatrician performs a newborn circumcision and uses a penile block, is this included in the code for the circumcision or is there a separate code?

Kathleen ONeill, RN
Office Manager
Cornerstone Medical Associates
Perry, GA

Answer: A penile block was not available at the time the circumcision code (54160) was created. Therefore, the actual work of a penile block was not included in the RVUs assigned. However, all surgical codes include the work of local anesthetic infiltration. Unless a separate code is created for this specific procedure, the block is included in the 54160.

Answers to Reader Questions and You Be the Coder contributed by: A.D. Jacobson, MD, FAAP, member, American Academy of Pediatrics Coding and Reimbursement Committee; Richard H. Tuck, MD, FAAP, member, American Academy of Pediatrics Coding and Reimbursement Committee; Richard A. Molteni, MD, FAAP, member, CPT Editorial Panel; Victoria Jackson, chairwoman, Pediatric Task Force Committee, Medical Group Management Association; Mark Reuben, MD, FAAP, president, Reading Pediatrics, Wyomissing, Pa.; Thomas Alan Kent, CMM, president, Kent Medical Management.