Results 1 to 8 of 8

Penile block with 54161

  1. Default Penile block with 54161
    Medical Coding Books
    Can You bill for a penile block 64450 when a circumcision 54161 is performed?
    I believe that the block is included but our physician disagrees.

    Thank You,

    Sherri Sadlocha

  2. #2
    is that the only anesthesia that was used? Did your doc perform the block himself?

  3. #3
    Duluth, Minnesota
    Per CCI Edits the two codes can be billed together - you'd need to put a .59 modifier on the 64450 though.

    Donna, CPC, CPC-H

  4. #4
    actually, I dont need the answers to those questions I previously posed (I was contemplating the use of the 47 modifier)

    You should use 54150 since it includes the penile block If you use 54161 and 64450 that would be unbundling.
    Last edited by mbort; 11-12-2008 at 01:57 PM.

  5. #5
    Duluth, Minnesota
    54150 & 54161 are quite different procedures. Done very differently. as far as bleeding is controlled vrs clamp ...among other things. But if in reality the provider did a 54161 (on a patient older than 28 days), the answer to your original question is yes - per CCI edits, 54161 and 64450 can be billed together. Modified accordingly, of course

    also, a local anesthetic injection is different than a nerve block
    Donna, CPC, CPC-H

  6. #6
    Donna is correct..the 54161 and 54150 are totally different techniques.

    IF the 54150 does not work for your particular scenario and the 54161 IS more appropriate, you may want to entertain using the 54161 w/47 modifier. According to Medicare Version CCI Edits 14.3 through Encoder Pro, 64450 DOES bundle (see below) with the 54161 and in "my opinion" does and would not qualify for the -59 modifier.

    In my opinion, the 47 modifier on the actual procedure code (IF your surgeon truly performed the block) is the more appropriate modifier to allow for additional reimbursement of the block.

    from Encoder:
    CCI Unbundles - 54161
    Selected Medicare CCI Version: 14.3
    Download National Correct Coding policy narratives now.

    Warning! These codes may not be billed together. Check to see if a modifier is allowed and supported by documentation.
    Last edited by mbort; 11-12-2008 at 03:30 PM.

  7. #7
    I would not bill the 64450 for either one; per CCI is included.

  8. #8
    Default Penile Block w/ 54161
    I agree with the CCI edit for 3rd quarter / append -59

Similar Threads

  1. Post Op Pain Block with Regional nerve block
    By lcole7465 in forum Anesthesia
    Replies: 2
    Last Post: 06-27-2015, 09:40 AM
  2. which new 59 modifier with penile block?
    By meenda in forum Pediatrics
    Replies: 1
    Last Post: 04-14-2015, 01:59 PM
  3. Penile block-64450
    By hopeu6 in forum Urology
    Replies: 2
    Last Post: 05-28-2010, 11:48 AM
  4. Penile Fx
    By KristieStokesCPC in forum Urology
    Replies: 6
    Last Post: 09-15-2009, 01:05 PM
  5. 54161??? Looks more extensive to me though...
    By mnowitzke in forum Urology
    Replies: 0
    Last Post: 04-29-2009, 08:06 AM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.