N48.0 — Leukoplakia of penis
ICD-10-CM
Prior Authorization
No Prior Auth Required
Code is 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 — CG-SURG-103 Penile Circumcision
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