A newborn circumcision is a procedure commonly performed by pediatricians but frequently denied or inappropriately bundled by payers. Newborn circumcisions, usually a well-reimbursed procedure, most of the time are preceded by a penile nerve block, which also is a separately reportable procedure that is frequently denied.

The Current Procedural Terminology (CPT) codes that are reported in conjunction with newborn circumcision include 54150 (circumcision, using clamp or other device; newborn) and 64450 (injection, anesthetic agent; other peripheral nerve or branch). (Note: This code can be used for either a ring block or a dorsal nerve block.)

If covered under the patient’s health care plan benefit package, a circumcision should be separately reimbursed by the payer, as it is not included in the newborn or other evaluation and management (E/M) service as described in the CPT guidelines. It should be noted, however, that a circumcision is a surgical procedure with a 10-day...

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