chisomnwaneri
Guest
When billing for circumcision, do I just bill for 54150 or can I also add A4550, can someone help me out
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Wiki Circumcision coding
- Thread starter chisomnwaneri
- Start date
julieordway
Networker
Just 54150 as the tray is usually included in the reimbursement of the CPT code. You can always try to bill for it and track to see if they pay for it. VERY few payors do.
jbhuju
Guru
does any insurance pay for circumcision?
TThivierge
True Blue
Hi
Ahh CPT 54130 is not circumcision but amputation/excision of the phallus. Circumcision surgery involves look at age of patient and differ problems with the phallus. Circumcision involved in coding is CPT 54160 is newborn less than 28 days old but CPT 54161 is older than 28 days old.
Just a little more information to share.
Lady T
Ahh CPT 54130 is not circumcision but amputation/excision of the phallus. Circumcision surgery involves look at age of patient and differ problems with the phallus. Circumcision involved in coding is CPT 54160 is newborn less than 28 days old but CPT 54161 is older than 28 days old.
Just a little more information to share.
Lady T
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I think you mis-read something. No one referenced 54130. The original post was with 54150 Circumcision, using clamp or other device with regional dorsal penile or ring block. That code is not age specific, and the only method I have seen (but are only performing on newborns).Hi
Ahh CPT 54130 is not circumcision but amputation/excision of the phallus. Circumcision surgery involves look at age of patient and differ problems with the phallus. Circumcision involved in coding is CPT 54160 is newborn less than 28 days old but CPT 54161 is older than 28 days old.
Just a little more information to share.
Lady T
The first question in the post was really asking about whether or not the surgical tray should be billed, and @julieordway gave an answer that I agree with 100%. Can you bill it? Yes. Will you get paid for it? Probably not. About 99.5% not in my experience billing a tray in general.
Then there was an additional question about whether or not an insurance would pay for a circumcision, to which I responded that I've never had an issue regarding newborns.
TThivierge
True Blue
CSPeroni,
Thank you for the correction!
Lady T
Thank you for the correction!
Lady T
julieordway
Networker
As far as ADULT CIRC's go, coverage policies vary. (I'm not familiar with newborn coverage) You need to check with your individual payor. MOST commercial plans cover it if medically necessary. If strictly for cosmetic reasons and patient is not having any problems (such as phimosis), you may have some issues. Always check pre-auth and coverage guidelines with your insurance plans.
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