Wiki Sebaceous cyst and Medicare

[medicalsec]

I was wondering if someone has been successful in getting Medicare to pay for a sebaceous cyst excision with pain being the main factor. Often, it is just irritating to the patient, rubbs against clothing, etc. I have only been able to get them paid if infection was involved. Appeals for pain have not been successful. I have experienced this with Palmetto and Noridan Medicare. Of course, they can sign the ABN, but since some are done in an outpatient facility rather than the office it becomes really expensive.

Thanks,

Dee

 

[sheardmd]

I may be way off here but we just code ours to the cyst (706.2) and we use the benign excision codes and we have never had a problem with payment. Right or wrong, we have been coding them like this for many years.