Back to dashboard
CommercialDocumentationMedium impact

Removal of Benign Skin Lesions and Scars

Blue Cross & Blue Shield of Mississippi·MS · Dermatology, Family Medicine, Internal Medicine +1 more·Medical Policy
Effective date
Not stated
We identified it
Jun 20, 2026
Days to comply

Summary

Blue Cross & Blue Shield of Mississippi updated their policy for removal of benign skin lesions and scars, maintaining strict medical necessity requirements. The policy clarifies that removal is only covered when specific symptoms are present (itching, burning, bleeding, inflammation, obstruction, or suspected malignancy) and requires detailed documentation to justify medical necessity versus cosmetic procedures.

Action Required

Action needed
Immediately: Providers must document specific medical necessity criteria before performing benign skin lesion removal procedures. Update EMR templates to require documentation of symptoms (itching, burning, bleeding, inflammation, size changes, or malignancy concerns) and lesion characteristics (location, physical appearance). Train billing staff to verify medical necessity documentation is present before submitting claims, as procedures without proper justification will be denied as cosmetic.

Affected Billing Codes

11400
11401
11402
11403
11404
11405
11406
11420
11421
11422
11423
11424
11425
11426
11440
11441
11442
11443
11444
11445
11446
11055
11056
11057
17000
17003
17004
17110
17111
17106
17107
17108
17250
12001
12002
12003
12004
12005
12006
12007
12011
12013
12014
12015
12016
12017
12018
12031
12032
12034
12035
12036
12037
12041
12042
12044
12045
12046
12047
12051
12052
12053
12054
12055
12056
12057
13100
13101
13102
13120
13121
13122
13131
13132
13133
13150
13151
13152