For Members


What is circumcision?

Circumcision refers to the removal of the foreskin, or prepuce that covers the glans penis (head of the penis).



Baby Vs Adult Circumcision
Circumcision surgery on male babies is fairly straightforward and commonplace. It is usually done for religious, medical or personal-choice reasons. However, the procedure in adults is less frequent, and more complicated in terms of surgical accuracy and skill required to achieve optimal patient results. Recovery time varies according to the age and general health of the person. A baby or child will generally heal in five to seven days after the procedure, while in adults, recovery can take around two to three weeks. If the circumcision is performed during the newborn period, it will take only about five to 10 minutes and it is performed under local anesthesia. For adults, it usually takes an hour approximately and it is performed under general anesthesia.



What are the indications for male circumcision?

  • Elective circumcision in adults can be performed for religious, cosmetic or personal reasons and is subject to prior approval from your insurer.
  • Male circumcision is considered medically necessary when the individual has any of the following conditions:
    • Preputial neoplasms; or
    • Recurrent balanitis; or
    • Recurrent balanoposthitis; or
    • Symptomatic phimosis; or
    • Paraphimosis; or
    • Tears of the frenulum; or
    • Trauma to the foreskin requiring surgical treatment.


Does my insurance cover Circumcision?

Coverage of Circumcision varies with different insurance policies and different local regulations: For Dubai based policy (DHA), medical necessary circumcision is covered for members upto 2 years old or below and will require prior approval. For Abu Dhabi based policy (DOH), circumcision is not covered. For Northern emirates, coverage of circumcisionvaries according to the table of benefit for each policy, please always all Nextcare to check if circumcision is covered.



For Healthcare Providers


For Medically Necessary Cases (e.g., Balanophospitis, Balanitis & Emergency Paraphimosis) detailed Medical report/s with confirmed clinical findings, medical management showing no improvements and has been exhausted, must be submitted at the pre-authorization level.

The below ICD-10 codes to be used:

ICD Description
C60.0-C60.9 Malignant neoplasm of penis
D07.4 Carcinoma in situ of penis
D29.0 Benign neoplasm of penis
D40.8 Neoplasm of uncertain behavior of other specified male genital organs
N47.0-N47.8 Disorders of prepuce
N48.0 Leukoplakia of penis
N48.1 Balanitis
Q54.0-Q54.9 Hypospadias
S31.20XA-S31.25XS Open wound of penis
S38.01XA-S38.01XS Crushing injury of penis
Z40.8-Z40.9 Encounter for other/unspecified prophylactic surgery

According to the procedure, use the below CPT codes:

CPT Description
54150 Circumcision, using clamp or other device with regional dorsal penile or ring block (all age)
54160 Circumcision, surgical excision other than clamp, device, or dorsal slit; neonate (28 days of age or less)
54161 older than 28 days of age
54162 Lysis or excision of penile post-circumcision adhesions
54163 Repair incomplete circumcision
54164 Frenulotomy of penis