Excision of Malignant Skin Lesions…

About this policy

Jurisdiction: J9 MAC Part B. States: Florida, Puerto Rico, US Virgin Islands. Type: Active LCD

Coverage indications

History/Background and/or General Information A skin lesion is any alteration in the normal skin architecture. Lesions can be benign, pre-malignant or malignant. The most common malignant lesions are Basal Cell Carcinomas (BCC), Squamous Cell Carcinomas (SCC) and Melanomas. Four of the most common methods of treatment of malignant skin lesions are: Surgical excision, Electrodesiccation (tissue destruction by heat), Radiation therapy, or Cryosurgery (tissue destruction by freezing) Covered Indications The treatment of choice for malignant skin lesions is complete excision that includes a variable margin of surrounding tissue in order to eradicate microscopic tumor cells, which may have spread beyond the visible borders of the lesion. The excision of a malignant skin lesion including margins will be considered medically necessary when a pathology report verifies the existence of a malignancy. Limitations As published in the CMS IOM Publication 100-08, Medicare Program Integrity Manual , Chapter 13, Section 13.5.4, an item or service may be covered by a contractor LCD if it is reasonable and necessary under the Social Security Act Section 1862 (a)(1)(A). Contractors shall determine and describe the circumstances under which the item or service is considered reasonable and necessary.

Codes in this policy

Code numbers and each code’s status as the policy records it. CPT code descriptions are left out of this page, as are the passages that cite CPT codes; the official document has them.

Codes this policy lists and each code’s status in the policy
Code	Code system	Status in this policy
11600	CPT	Covered
11601	CPT	Covered
11602	CPT	Covered
11603	CPT	Covered
11604	CPT	Covered
11606	CPT	Covered
11620	CPT	Covered
11621	CPT	Covered
11622	CPT	Covered
11623	CPT	Covered
11624	CPT	Covered
11626	CPT	Covered
11640	CPT

Coverage indications

Codes in this policy

Code numbers and each code’s status as the policy records it. CPT code descriptions are left out of this page, as are the passages that cite CPT codes; the official document has them.

Codes this policy lists and each code’s status in the policy
Code	Code system	Status in this policy
11600	CPT	Covered
11601	CPT	Covered
11602	CPT	Covered
11603	CPT	Covered
11604	CPT	Covered
11606	CPT	Covered
11620	CPT	Covered
11621	CPT	Covered
11622	CPT	Covered
11623	CPT	Covered
11624	CPT	Covered
11626	CPT	Covered
11640	CPT

About this policy

Coverage indications

Codes in this policy

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About this policy

Coverage indications

Codes in this policy

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