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Section: Surgery
Number: S-36
Topic: Removal of Multiple Skin Lesions
Effective Date: August 28, 2000
Issued Date: August 28, 2000
Date Last Reviewed:

General Policy Guidelines | Procedure Codes | Traditional (UCR/Fee Schedule) Guidelines | FEP Guidelines | Comprehensive/Wraparound/PPO Guidelines | Managed Care (HMO/POS) Guidelines | Publications | View Previous Versions | Attachments | Glossary

General Policy Guidelines

The removal of lesions can be identified by the codes appropriate to the type of removal as well as the type and number of lesions, e.g., 11400-11446 for excision of benign lesions, 11600-11646 for excision of malignant lesions and 17000-17004 for chemosurgical, cryosurgical, or electrosurgical destruction of lesions.

Multiple procedures up to and including five at one session are priced in accordance with the multiple surgery guidelines on Medical Policy Bulletin S-100.

Removal of lesions in excess of five at one session are priced at ten percent of the allowance, providing this amount does not exceed the billed charge.

More than five procedures or unusual circumstances should be given a medical review.

Procedure Codes

110551105611057112001120111300
113011130211303113051130611307
113081131011311113121131311400
114011140211403114041140611420
114211142211423114241142611440
114411144211443114441144611600
116011160211603116041160611620
116211162211623116241162611640
116411164211643116441164617000
170031700417110171111726017261
172621726317264172661727017271
172721727317274172761728017281
17282172831728417286X1720 

Traditional (UCR/Fee Schedule) Guidelines

Refer to General Policy Guidelines

FEP Guidelines

Refer to General Policy Guidelines

Comprehensive/Wraparound/PPO Guidelines

Refer to General Policy Guidelines

Managed Care (HMO/POS) Guidelines

Refer to General Policy Guidelines

Publications

References

View Previous Versions

No Previous Versions

Table Attachment


Text Attachment

Procedure Code Attachment


Glossary

TermDescription





Medical policies do not constitute medical advice, nor are they intended to govern the practice of medicine. They are intended to reflect Highmark's reimbursement and coverage guidelines. Coverage for services may vary for individual members, based on the terms of the benefit contract.

Highmark retains the right to review and update its medical policy guidelines at its sole discretion. These guidelines are the proprietary information of Highmark. Any sale, copying or dissemination of the medical policies is prohibited; however, limited copying of medical policies is permitted for individual use.


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