ICD-10 Code for recurrent physical trauma of skin

jleavit2

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Our LCD says that benign lesion removals (shaves, excisions, skin tags, destruction) will be covered when the "lesion is in an anatomical region subject to recurrent physical trauma and there is documentation that such trauma has in fact occurred." For example, documentation says, "lesion constantly rubs on bra strap and it's driving the patient crazy."

What ICD-10 code can I use to communicate to insurance that the lesion removal was medically necessary?
 

ellzeycoding

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What state are you in? LCDs vary from carrier to carrier.

Some state's LCDs have Lists of Codes. One list shows codes that themselves show medical necessitywithout another code. Other LCDs have a list of CD-10 codes in one list require a code from a different list to show medical necessity.

And then, some states don't require a second code to show medical necessity, only that it's documented.

For example, here is a California LCD.

https://www.cms.gov/medicare-coverage-database/details/lcd-details.aspx?LCDId=34233

List I can be coded by themselves to show medical necessity

List II requires a complication from List III.

Thinks like "itching" can be categorized as R20.8 "Other disturbances of skin sensation" as a List III code
Bleeding can be R58 "Hemorrhage, not else where classified" as a List III code
 

jleavit2

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I am in Utah and our carrier is Noridian. Our LCD is very similar to California's; maybe it's the exact same.

Which ICD-10 code from group 3 would coincide with "F. The lesion is in an anatomical region subject to recurrent physical trauma and there is documentation that such trauma has in fact occurred." from the Coverage Guidance section?
 
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