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Blue Cross & Blue Shield of MississippiCommercial · Coverage · Medical Policy · MS · Dermatology, Plastic SurgeryMedium impact

Removal of Benign Skin Lesions and Scars

Effective date
Not stated in the notice
Identified
Jun 20, 2026

Summary

Cosmetic surgery and any complications of cosmetic surgery are not eligible for coverage, including any operative procedure or portion of one intended solely to improve physical appearance. Removal of seborrheic keratoses, sebaceous (epidermoid) cysts, nevi, papillomas and viral warts (excluding condyloma acuminatum) is medically necessary only when the lesion is symptomatic or has objective signs or symptoms listed in the policy, such as itching, burning, irritation, significant change in color or size or bleeding, physical evidence of inflammation, obstruction of an orifice or clinically restricted vision, clinical uncertainty about malignancy, a prior biopsy indicative of malignancy, or recurrent physical trauma that is documented to have occurred. Removal for reasons such as emotional distress, "makeup trapping" or location alone is considered cosmetic and not medically necessary.

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What to do

Action · 12 steps
01REQUIREMENTS: Document the medical necessity for each lesion removal in the physician's medical records, with a written description of each surgically treated lesion in terms of location and physical characteristics.
02A non-specific diagnosis such as "skin lesion" without documented signs and symptoms is not sufficient justification for lesion removal.
03Use of ICD-9-CM code 702.11 is insufficient without medical record documentation of the patient's symptoms and physical findings.
04When size change is present, document the size change.
05Keep the documentation that establishes medical necessity of each service with the patient's record.
06For a benign lesion excision (CPT 11400-11446), document why an excisional removal, other than for cosmetic purposes, was the procedure of choice.
07BCBSMS makes no payment for services not documented to be medically necessary, and a provider's order or recommendation does not in itself make a service medically necessary.
08The physician must notify the patient in advance that Blue Cross & Blue Shield of Mississippi will not cover cosmetic dermatological surgery and that the subscriber will be liable for the cost, and a written notification with the subscriber's signature is strongly advised, with charges clearly stated.
09Separate payment is not made for simple repairs (CPT 12001-12018) reported with excision of benign or malignant lesions.
10Intermediate repair (CPT 12031-12057) or complex repair (CPT 13100-13152) may be reported separately when medically necessary.
11Follow CPT coding guidelines when an evaluation and management service is reported on the same day as a dermatological surgical procedure.
12Office visits are covered when the diagnosis of a benign skin lesion is made, even if no removal is done.

Codes mentioned

110551105611057113001130111302113031130511306113071130811310113111131211313114001140111402114031140411406114201142111422114231142411426114401144111442114431144411446120011201812031120571310013152170001700317004171061710717108171101711117250B08.1B07.9B07.0B07.8D12.7D12.9D17.0D17.1D17.39D22.0D23.9H02.821H02.829I78.0I78.1N44.1N44.2N50.3N60.81N60.82N60.89N94.89L82.0L82.1L72.3R20.0R20.9Z85.820Z85.828

Original notice

Removal of Benign Skin Lesions and Scars
bcbsms.com · Always check the source before changing claims.
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Related changes

See all Blue Cross & Blue Shield of Mississippi changes →
Non-Pharmacologic Treatment of RosaceaMediumNo effective date · Medical PolicyLaser Treatment of Congenital Port Wine Stain HemangiomasMediumNo effective date · Medical PolicyTransanal Endoscopic MicrosurgeryLowNo effective date · Medical PolicyBrowse every Blue Cross & Blue Shield of Mississippi change in the policy list

Related policy hubs

Blue Cross & Blue Shield of Mississippi policiesMS policy changesDermatologyPlastic SurgeryCode 11055Code 11056Code 11057Code 11300Code 11301Code 11302Code 11303Code 11305Code 11306Code 11307Code 11308Code 11310Code 11311Code 11312Code 11313Code 11400Code 11401Code 11402Code 11403Code 11404Code 11406Code 11420Code 11421Code 11422Code 11423Code 11424Code 11426Code 11440Code 11441Code 11442Code 11443Code 11444Code 11446Code 12001Code 12018Code 12031Code 12057Code 13100Code 13152Code 17000Code 17003Code 17004Code 17106Code 17107Code 17108Code 17110Code 17111Code 17250Code B08.1Code B07.9Code B07.0Code B07.8Code D12.7Code D12.9Code D17.0Code D17.1Code D17.39Code D22.0Code D23.9Code H02.821Code H02.829Code I78.0Code I78.1Code N44.1Code N44.2Code N50.3Code N60.81Code N60.82Code N60.89Code N94.89Code L82.0Code L82.1Code L72.3Code R20.0Code R20.9Code Z85.820Code Z85.828

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