© Copyright 2025 American Medical Association. All rights reserved.
A male circumcision is a surgical procedure that involves the excision or removal of the prepuce, commonly known as the foreskin, which is the fold of skin that covers the glans penis in uncircumcised males. This specific procedure, coded as CPT® 54160, is performed on neonates, defined as patients who are 28 days of age or less. The circumcision is executed using a method that does not involve a clamp, device, or dorsal slit technique, indicating a more traditional freehand approach. Prior to the procedure, a local anesthetic is typically administered to minimize discomfort for the neonate. In cases where the procedure is performed on older children or adults, a general anesthetic may be utilized instead. It is important to note that for patients older than 28 days, the appropriate code to use is CPT® 54161. This distinction is crucial for accurate medical coding and billing purposes.
© Copyright 2025 Coding Ahead. All rights reserved.
The procedure of circumcision, specifically CPT® 54160, is indicated for neonates who may require the removal of the foreskin for various reasons. These indications may include:
The circumcision procedure coded as CPT® 54160 involves several key steps, which are detailed as follows:
Following the circumcision procedure, the neonate is monitored for any immediate complications, such as excessive bleeding or signs of infection. Parents or guardians are provided with detailed post-operative care instructions, which may include keeping the surgical site clean and dry, monitoring for any unusual symptoms, and managing pain with appropriate medications as prescribed. The expected recovery time is generally short, with most neonates returning to normal activities within a few days. Follow-up appointments may be scheduled to ensure proper healing and address any concerns that may arise during the recovery period.
| Short Descr | CIRCUMCISION NEONATE | Medium Descr | CIRCUMCISION NEONATE | Long Descr | Circumcision, surgical excision other than clamp, device, or dorsal slit; neonate (28 days of age or less) | Status Code | Active Code | Global Days | 010 - Minor Procedure | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 2 - Standard payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 1 - Statutory payment restriction for assistants at surgery applies to this procedure... | Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Hospital Part B services paid through a comprehensive APC | ASC Payment Indicator | Surgical procedure on ASC list in CY 2007; payment based on OPPS relative payment weight. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P6C - Minor procedures - other (Medicare fee schedule) | MUE | 1 | CCS Clinical Classification | 115 - Circumcision |
| 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure |
|
Date
|
Action
|
Notes
|
|---|---|---|
| 2011-01-01 | Changed | Short description changed. |
| 2007-01-01 | Changed | Code description changed. |
| Pre-1990 | Added | Code added. |
Get instant expert-level medical coding assistance.