Billing and Coding: Removal of Benign Skin Lesions

Medicare coverage for removal of benign skin lesions requires documentation of medical necessity, appropriate ICD-10-CM diagnosis codes, and signed clinical records; excisional procedures (CPT 11400-11446) require specific rationale if not cosmetic and lesion-plus-margin measurements recorded prior to excision. Claims missing valid ICD-10 codes or lacking required documentation (including ABN/CMS‑R‑131 when applicable) may be returned or denied, and billing must report each excised lesion separately with applicable modifiers and billing rules observed.

"Excision of a benign skin lesion is covered when there is clinical suspicion of malignancy (e."

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