Wiki Skin tag 11200

[Tenniers]

Hello,
We are seeing some issues come up with CPT 11200 when using DX L91.8. Ins saying not covered.
What does everyone else use when PT has a Skin Tag or Inflamed skin tag. When its not Cosmetic and billing Ins?

Thanks!

 

[trarut]

If L91.8 is the correct ICD-10 code, you can't simply pick another one to get paid for the service. Have you reviewed the payer's policy for procedure? You may need to look at the patient's benefits - It may simply be a non-covered service. I can't recall a single personal insurance policy I've had over the years that would cover skin tag removal. If I needed it done, I knew it would be non-covered and I've be paying out of pocket.

 

[nkrush12]

Agree, cannot change DX to get paid. Here in MN we do have a few commercial plans that will pay for irritate skin tags (most will have a benign lesion medical policy) but skin tags are a no go for all of our Cigna and out of state BCBS patients.