Does D17.23 require prior authorization?

No, D17.23 does not require prior authorization (high confidence). Covered without prior authorization.

`D17.23`, Benign lipomatous neoplasm of skin and subcutaneous tissue of right leg

ICD-10-CM

No Prior Auth Required

Covered without prior authorization (high confidence)

This billing/coding guideline complements LCD L33459 (Computerized Axial Tomography (CT), Thorax); follow the LCD for clinical coverage and any required documentation or prior authorization rules.
When billing J7999-KD, enter the name and total dose (mg or mcg) of each drug in Box 19 of the CMS-1500 or the appropriate electronic comment loop; if Box 19 cannot accommodate all information, attach the details to the paper claim.
If a portion of a single-dose vial is not used, submit the HCPCS code for the drug on a separate claim line and append modifier JW to indicate discarded/unused portion.

Compounded medications for use in implantable infusion pumps may be covered by Medicare when their use meets all other criteria for services provided incident to a physician's service.
True off-the-shelf (non‑compounded) drugs used without compounding and administered via DME may be billed using the drug-specific HCPCS code and are reimbursed under CMS ASP methodology.
If Prialt® is implanted as a single agent in the pump, bill using HCPCS code J2278-KD.
Compounded single-agent or combination drug formulations used in implanted infusion pumps must be billed using HCPCS code J7999-KD for reimbursement.
Excision of a benign skin lesion is covered when there is clinical suspicion of malignancy (e.g., ICD-10-CM D48.5) documented in the medical record.
Removal is covered to address disturbance of skin sensation when documented (ICD-10-CM R20.0-R20.3, R20.8).

CGS-J15-L34200, Removal of Benign Skin Lesions

J15

CGS-J18-L34200, Removal of Benign Skin Lesions

J18

WPS-J5-L35498, Removal of Benign Skin Lesions

A57482, Billing and Coding: Removal of Benign Skin Lesions

A57452, Billing and Coding: Peripheral Nerve Blocks

NGS-J6-L36850, Peripheral Nerve Blocks

WPS-J8-L35498, Removal of Benign Skin Lesions

FIRST_COAST-L33933, Peripheral Nerve Blocks

NOVITAS-JH-L34938, Removal of Benign Skin Lesions

NGS-JK-L36850, Peripheral Nerve Blocks

NOVITAS-JL-L34938, Removal of Benign Skin Lesions

A57113, Billing and Coding: Removal of Benign Skin Lesions

A57161, Billing and Coding: Benign Skin Lesion Removal (Excludes Actinic Keratosis, and Mohs)

A56580, Billing and Coding: Computerized Axial Tomography (CT), Thorax

A57788, Billing and Coding: Peripheral Nerve Blocks

A56695, Billing and Coding: Implantable Infusion Pump

A57044, Billing and Coding: Removal of Benign Skin Lesions