Mohs Micrographic Surgery
L35704
Mohs is covered for specified BCC, SCC, lentigo maligna/melanoma in situ and select rare skin cancers when the tumor subtype, size, anatomic area (H/M/L) and patient immune status meet the LCD tables (with frequent exclusions or limits on Area L and explicit non‑coverage for AK with focal SCC in situ, Bowenoid AK/SCC‑in‑situ AK type and bowenoid papulosis). Key requirements: an MD/DO must perform both the surgical and immediate histologic services, medical records must justify MMS over simple excision (documenting site area, size, depth, histology and immunocompromised/genetic status), billing uses tissue blocks, and certain diagnoses (e.g., angiosarcoma, desmoplastic trichoepithelioma) are subject to records review/pre‑payment or redetermination.
"Squamous Cell Carcinoma (SCC) - Primary aggressive (healthy patients) — all sizes: Area H, M, and L."
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