MedicaidPrior AuthLow impact
Attention Provider Type 10 (Outpatient Surgery, Hospital Based): Reminder of Prior Authorization Requirement for Procedure Code 54160
Nevada Medicaid·NV · Urology, General Surgery, Pediatrics·Prior Authorization
We identified it
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.
Action Required
Immediately: Billing 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. Update billing system reminders if needed. Claims without prior auth for eligible patients will be denied.