Are You Reporting Circumcision With Nerve Blocks Correctly?

There are some new guidelines for reporting a nerve block with a circumcision. In the past you may have reported this as two separate procedures using 54150 to document the circumcision and 64450 for the accompanying nerve block.

However the AMA has revised code 54150 (Circumcision, using clamp or other device with regional dorsal penile or ring block) in the new edition of CPT 2007 to include the accompanying nerve block in the description of the service. As such, it would now be unnecessary to report 64450 (Injection, anesthetic agent; other peripheral nerve or branch) with 54150 for this purpose, and the National Correct Coding Initiative (NCCI) bundles 64450 into 54150 for this reason.

It is however, permissible to append a modifier because the NCCI edit carries an indicator of “1,”; physicians can append a modifier (such as modifier 59, Distinct procedural service) to 64450 along with documentation showing that they used 64450 as regional anesthesia for other reasons. As always, make sure that your medical billing documentation is iron clad and it will ensure that you get the correct reimbursement for this procedure.

Keeping up with the CPT codes can cost your practice money if your staff submits claims using outdated coding. Make sure that your practice gets the proper reimbursements for the services you provide; if you’re experiencing rejections or partial payments – it may be time to consider outsourcing.

View all Articles by: Melissa Clark, CCS-P