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NC Division of Medical Assistance
Medically Necessary Circumcision Medicaid and Health Choice
Clinical Coverage Policy No: 1A22
Amended Date: October 1, 2015Table of Contents
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What is medically necessary circumcision?
Medically necessary circumcision is a procedure that is deemed necessary for medical reasons, such as treating a medical condition or preventing future health problems.
Who is required to file medically necessary circumcision?
The healthcare provider or facility performing the circumcision is required to file the necessary paperwork for medically necessary circumcision.
How to fill out medically necessary circumcision?
The healthcare provider or facility will need to include specific information about the patient, the medical necessity of the procedure, and any relevant medical history when filling out the paperwork for medically necessary circumcision.
What is the purpose of medically necessary circumcision?
The purpose of medically necessary circumcision is to address a medical issue or prevent future health problems that can be alleviated through the procedure.
What information must be reported on medically necessary circumcision?
Information such as the patient's medical history, the reason for the procedure, and any relevant health information must be reported on documents related to medically necessary circumcision.
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