Benign Skin Lesion Removal (Excludes Actinic Keratosis, and Mohs)
L33979
Medicare covers removal of specified benign skin lesions (seborrheic keratoses, skin tags, milia, molluscum contagiosum, sebaceous/epidermoid cysts, nevi, acquired hyperkeratosis and viral warts except condyloma acuminatum) as medically necessary — not cosmetic — only when clearly documented criteria are met (e.g., bleeding, intense itching, pain, purulence/oozing/edema/erythema, obstruction or vision restriction, diagnostic uncertainty or prior biopsy suggesting (pre)malignancy, recurrent physical trauma to the area, or wart-specific indications such as periocular warts causing chronic conjunctivitis or documented spread between body areas, especially in immunocompromised patients). Actinic keratosis (covered under NCD 250.4), Mohs, cosmetic removals, routine foot care, and other non-addressed lesions are excluded, and all medical necessity justifications must be documented in the chart (subject to post-payment review).
"This policy applies to the following: seborrheic keratoses, skin tags, milia, molluscum contagiosum, sebaceous (epidermoid) cysts, moles (nevi), acquired hyperkeratosis (keratoderma) and viral wart..."