CMS Destruction of Malignant Skin Lesions Form

Effective Date

01/08/2019

Last Reviewed

11/22/2019

Original Document

  Reference



Background for this Policy

Summary Of Evidence

N/A

Analysis of Evidence

N/A

Covered Indications

Destruction of malignant skin lesions

The destruction of malignant skin lesions will be considered medically necessary in the following circumstances: 

  • When a pathology report confirms the diagnosis of a skin malignancy, and/or 
  • When the description of the lesion is consistent with that of a skin malignancy.

Limitations

As published in the CMS IOM Publication 100-08, Medicare Program Integrity Manual, Chapter 13, Section 13.5.4, an item or service may be covered by a contractor LCD if it is reasonable and necessary under the Social Security Act Section 1862 (a)(1)(A). Contractors shall determine and describe the circumstances under which the item or service is considered reasonable and necessary.