Excisions: Removal of lipomas, sebhorrheic keratoses, skin tags

Applies to:

Commercial group HMO, EPO, POS and PPO plans

Commercial individual MyPriority® plans

Priority Health Choice plans (Medicaid and Healthy Michigan Plan)

Priority Health Medicare plans

Definition

Surgical excision of lipomas, sebhorrheic keratoses, and skin tags, as defined by the CPT codes below.

Excisions coverage

All excisions are covered as a single category at non-standard cost-sharing levels. See below the diagnosis codes for more information on non-standard cost-sharing.

Lipomas: All surgical services (CPT codes 10000-69999) billed with these diagnoses:

  • 214.0, 214.1, 214.9, subcutaneous lipoma
  • D170-D17.39, benign lipomatous neoplasm of skin and subcutaneous tissue

Sebhorrheic keratoses: All surgical services (CPT codes 10000-69999) billed with these diagnoses:

  • 702.11, 702.19
  • L82.0, inflamed seborrheic keratosis
  • L82.1, other seborrheic keratosis

Skin tags:

  • 11200, removal of skin tags, multiple fibrocutaneous tags, any area: up to and including 15 lesions
  • 11201, removal of skin tags, multiple fibrocutaneous tags, any area; each additional 10 lesions (list separately in addition to code for primary procedure)

Non-standard cost-sharing

If/when commercial employer group and MyPriority® individual plans cover certain surgeries, these surgeries are covered at a different cost-sharing level than our standard benefit coverage levels.

To verify member cost sharing, use the Member Inquiry tool and look in the Additional benefits drop-down menu for Certain surgeries benefit information.