Medicare AdvantageCoverageMedium impact
MA11.103c, Chemical Peels
Independence Blue Cross·Dermatology, Plastic Surgery, General Surgery·Medical Policy
Effective date
Dec 29, 2025
We identified it
Jun 19, 2026
Summary
Independence Blue Cross Medicare Advantage reissued MA11.103c to clarify that chemical peels for actinic keratoses are now covered WITHOUT restrictions based on lesion count or patient characteristics. The policy also removed ICD-10 diagnosis code L57.9 and maintains coverage criteria for dermal peels treating other premalignant lesions (requiring >10 lesions and failed topical therapy), while epidermal peels for non-actinic keratosis premalignant lesions remain non-covered.
Action Required
By December 29, 2025: (1) Billing team must update claim submission logic to remove any restrictions or lesion count requirements for CPT 15789 and 15793 when billed with ICD-10 L57.0 (actinic keratosis). (2) Remove ICD-10 code L57.9 from billing system and policy reference materials. (3) For CPT 15788 and 15792 (epidermal peels) treating premalignant lesions other than actinic keratosis: maintain denial protocols as these remain non-covered. (4) For CPT 15789 and 15793 (dermal peels) treating premalignant lesions other than actinic keratosis: continue requiring prior authorization documentation showing (a) >10 lesions AND (b) failed or contraindicated topical 5-FU or imiquimod therapy. (5) Update encounter templates and provider documentation checklists to reflect that actinic keratosis chemical peels no longer require lesion count justification. (6) Train billing and authorization staff on the expanded coverage for actinic keratosis peels to prevent unnecessary denials. Failure to implement by the effective date may result in claim denials for eligible actinic keratosis cases or incorrect approvals for non-covered epidermal peel scenarios.