Wiki Scar Revision

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NPSDEB

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Hello all-
Has anyone found a way to bill for scar revision? Since we can no longer use the complex repair codes we are at a loss as to what to use. Cannot use the lesion removal codes since there is a LCD for that and L90.5 is not on that list. I am meeting with my provider this afternoon to discuss this as he wants "to get paid for what he does and some are extensive". I totally agree with this but don't know what to tell him. Thank you for any and all input.

Deb
 
L90.5 wouldn’t meet medical necessity requirements for benign lesion removal codes, but L91.0 should. If the surgeon is revising a scar for cosmetic reasons, insurance won’t cover that.
 
NPSDEB said:
Hello all-
Has anyone found a way to bill for scar revision? Since we can no longer use the complex repair codes we are at a loss as to what to use. Cannot use the lesion removal codes since there is a LCD for that and L90.5 is not on that list. I am meeting with my provider this afternoon to discuss this as he wants "to get paid for what he does and some are extensive". I totally agree with this but don't know what to tell him. Thank you for any and all input.

Deb
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You are to use the appropriate complex repair CPT code for scar revision.
 
LisaAlonso23 said:
You are to use the appropriate complex repair CPT code for scar revision.
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The complex repair codes were revised in 2020 and no longer include scar revision hence our confusion on what to use. We have had post payment audits and they have recouped the payment on our complex repair codes.
 
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