Removal of Benign Skin Lesions

Medicare covers destruction of actinic keratoses without restriction and will consider removal of specified benign skin lesions (seborrheic keratoses, epidermoid cysts, skin tags, nevi, keratoderma, molluscum, milia, viral warts) medically necessary only when clearly documented clinical indications exist (e.g., bleeding, pain, infection, functional obstruction, diagnostic uncertainty, malignancy on biopsy, recurrent trauma). Lesion removal performed solely for cosmetic reasons, including non-problematic or location-only concerns, is not covered and the beneficiary is financially liable; physicians should notify patients and obtain signed acceptance of payment. Billing limitations apply for same-day or global-period E&M services unless a significant, separately identifiable service is documented (use modifier 25 where applicable).

"Destruction of actinic keratoses is covered without restrictions based on lesion or patient characteristics."