Cosmetic and Reconstructive Surgery - MEDICAID - VIRGINIA

This policy covers medically necessary reconstructive surgery and related procedures (e.g., scar revision, excision of excess skin, cutaneous vascular lesion removal, chemical peels 15789/15792/15793, dermabrasion 15783) performed to improve or restore bodily function. Coverage is limited to patients with an objective, demonstrable functional impairment from congenital anomalies, developmental defects, trauma, infection, tumors, disease or bodily injury (chemical peels/dermabrasion are allowed only for actinic keratoses); purely cosmetic procedures are excluded and eligibility is subject to member/plan requirements and documentation of medical necessity.

"15832 - Excision, excessive skin and subcutaneous tissue (includes lipectomy); thigh"

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