Mohs Micrographic Surgery

Mohs Micrographic Surgery (MMS) is covered when used for complex, recurrent, aggressive, or anatomically sensitive skin cancers as specified by lesion type, size, and body area per the 2012 Appropriate Use Criteria. Coverage requires that the surgeon personally perform both the staged excision and immediate histologic evaluation, that physician training and facility laboratory capabilities be verifiable, and that medical necessity and repair plans are documented; several lesion/area/size combinations and benign conditions (e.g., certain AK types) are specifically excluded.

"Recurrent basal cell carcinoma (BCC) of any size or an unexpected positive margin on recent excision is covered for MMS."

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