Insurance and Medical Coding Test Prep

Category - Free Coding Specialist Practice Test

A pediatrician performed a routine circumcision on a newborn baby boy in a hospital setting. The physician anesthetized the area with dorsal penile block, clamped the foreskin away from the tip of the penis and excised the excess foreskin. What is the correct code for the circumcision?
  1. 54160
  2. 54150 -47
  3. 54150
  4. 54160 -47
Explanation
Answer: C - The correct code for the circumcision is 54150 (Circumcision, Using Clamp or Other Device with Regional Dorsal penile or Ring Block). Code 54160 is not correct because it is used for a circumcision without using a clamp or other device. You should not use modifier -47 (Anesthesia by Physician) because the anesthesia was included in the procedure description. Modifier -47 guidelines state that the modifier is not to be used with local anesthesia and a penile ring block is a local anesthetic.
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