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Nevada MedicaidMedicaid · Prior Auth · Prior Authorization · NV · Urology, General Surgery, PediatricsLow impact

Attention Provider Type 10 (Outpatient Surgery, Hospital Based): Reminder of Prior Authorization Requirement for Procedure Code 54160

Act
immediately
Effective date
Not stated in the notice
Identified
Jun 21, 2026

Summary

Nevada Medicaid is reminding hospital-based outpatient surgery providers that CPT code 54160 (Circumcision Neonate) requires prior authorization only for patients age 1 year or older. This is a reminder of an existing requirement, not a new policy change.

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What to do

immediately · 3 steps
01Billing team must verify that prior authorization is obtained for CPT 54160 (Circumcision Neonate) when performed on patients age 1 year or older for Nevada Medicaid claims.
02Update billing system reminders if needed.
03Claims without prior auth for eligible patients will be denied.

Codes mentioned

54160

Original notice

Attention Provider Type 10 (Outpatient Surgery, Hospital Based): Reminder of Prior Authorization Requirement for Procedure Code 54160
medicaid.nv.gov · Always check the source before changing claims.
View original ↗

Related policy hubs

Nevada Medicaid policiesNV policy changesUrologyGeneral SurgeryPediatricsCode 54160

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