Skip to main content

ICD-10-CM Q54.9, Hypospadias, unspecified | No Prior Auth

Backwork Sign up free

Ask Backwork/Q54.9

`Q54.9`, Hypospadias, unspecified

ICD-10-CM

Prior Authorization

No Prior Auth Required

Covered without prior authorization (high confidence)

Key Coverage Criteria

Penile circumcision is consideredmedically necessarywhen the individual hasanyof the following conditions:Preputial neoplasms;orRecurrent balanitis;orRecurrent balanoposthitis;orRisk reduction for individuals at high risk of HIV infection;orSymptomatic phimosis;orParaphimosis;orTears of the frenulum;orTrauma to the foreskin requiring surgical treatment.
Preputial neoplasms;or
Recurrent balanitis;or
Recurrent balanoposthitis;or
Risk reduction for individuals at high risk of HIV infection;or
Symptomatic phimosis;or

1 Active Policy

ANTHEM-CG-SURG-103, Penile Circumcision

Related Codes

C60.0(1 policies)C60.9(1 policies)D07.4(1 policies)D29.0(1 policies)D40.8(1 policies)N47.0(1 policies)N47.8(1 policies)54161(1 policies)

Have a follow-up question?

Ask Backwork about documentation requirements, denial risks, or coverage in your state.

Ask Backwork about Q54.9 Sign up free