Wiki Enlarging skin lesion/cyst diagnosis

[PMiklavcic]

What 2ndary code on the LCD covers "enlarging?"

Our provider excised a sebaceous cyst that was growing, no other complications. Medicare requires a 2nd dx to justify the reason for removal. "Enlarging" is listed on the indications for removal, I just can't pair up an appropriate dx that is covered from the LCD. I originally used L98.9 (Disorder of the skin and subcutaneous tissue, unspecified) but the scrubber kicked it back stating this dx was not on the LCD list. I have exhausted all efforts, HELP!!!

Thank you!!

 

[thomas7331]

A sebaceous cyst should be coded with L72.3. There is no separate ICD-10 code for enlarging. If this code doesn't pass the edits, then you would just need to submit and let it deny, then appeal the denial with records showing that the characteristics of the lesion that are documented for the patient meet the criteria in the LCD to support the medical necessity of the excision.

 

[PMiklavcic]

Yes, I did use the L72.3 for the primary dx code. Thank you so much for your expertise!