Melanocytic nevi are what we would traditionally call "moles". Dark colored splotches on your skin with well-defined boarders, etc. that aren't typical of other dark patch conditions like birthmarks or worse conditions like malignant melanoma,. These fall in to the D22
series and have their own ICD-10 series. D22 series is specific for the typical "mole" codes
The D23 or "Other benign neoplasms" is a "catch all" for all of the other conditions that don't have a specific ICD-10 series.
I have over 277 synonyms and cross-refrenced diagnoses in our DermCoder tool. You will notice that nevus or nevi aren't in this series. They fall into D22.
I've attached the list of synonyms to this reply.
So, if your lab is coding what your provider considers to be moles in the D22 series, they are correct.
I know I'm going around and around with you on several threads about this. The problem is your Pennsylvania Medicare carrier's LCD doesn't allow all many of the moles to be removed as benign lesions. In my professional opinion, this is a deficiency
in their policy. You could campaign with their medical director to get them added to their LCD, or get the American Academy of Dermatology involved. PA's LCD is missing a LOT of the D22 series as covered diagnoses that most other carriers typically cover. You can try and change it!
Having the lab "Change" diagnoses for payment purposes would be considered F-R-A-U-D. Unless they are coding incorrectly
. From what you are saying, they are not.
I understand where your office is coming from. The doctor considers them medically necessary to remove. He is probably right. However, some of the mole codes (like the ones on the trunk), your carrier doesn't consider medically necessary. Perhaps you can change it for the benefit of your practice and others in the state of PA.
Your carrier DOES cover some of the D22 series, only the face ones, though.
I am going to guess that they don't consider regular moles of the trunk to be considered medically necessary because they are generally not sun-exposed areas, such as moles on the face. Just a hunch. But I still think they are wrong.
This would be similar to MOHS being covereed for BCCs only on certain areas (like the face) for some carriers.