Urology Coding Alert

Reader Question:

Nerve Block

Question: I have heard that 64450 is the correct code for a dorsal penile nerve block when performing a circumcision on a newborn. What code should we use for a ring block?

New Jersey Subscriber

Answer: Medicare will not pay the same physician who performs a surgical procedure to administer anesthesia, but your scenario is clearly not applicable to Medicare.

You may use 64450* (Injection, anesthetic agent; other peripheral nerve or branch) for either a dorsal penile nerve block or a ring block. Bill this code with 54150 (Circumcision, using clamp or other device; newborn). The main penile nerve runs along the dorsal or top aspect of the penis. You could inject at that one area, which is a dorsal block. A circular block or ring block also injects the dorsal nerve.

 

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