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Contractor Information

Contractor Name: Palmetto GBA - Full list of policies of this Medicare Contractor Contractor Number: 10111 Contractor Type: MAC A

LCD Information

LCD ID Number: L33445 Status: A-Approved LCD Title: Removal of Benign and Malignant Skin Lesions Geographic Jurisdiction: Alabama Other Jurisdictions Original Determination Effective Date: 10/01/2015 Original Determination Ending Date: Revision Effective Date: 10/23/2025 Revision End Date: CMS National Coverage Policy: Title XVIII of the Social Security Act, §1862(a)(1)(A) allows coverage and payment for only those services that are considered to be reasonable and necessary for the diagnosis or treatment of illness or injury or to improve the functioning of a malformed body member. Title XVIII of the Social Security Act §1862(a)(10) excludes Medicare coverage for cosmetic surgery, except as required for the prompt repair of accidental injury or for improvement of the functioning of a malformed body member. 42 CFR 411.15(h) Particular services excluded from coverage: Cosmetic surgery and related services CMS Internet-Only Manual, Pub. 100-03, Medicare National Coverage Determinations (NCD) Manual, Chapter 1, Part 4, §250.4 Treatment of Actinic Keratosis CMS Internet-Only Manual, Pub. 100-02, Medicare Benefit Policy Manual, Chapter 15, §60.1 Incident to Physician’s Professional Services CMS Internet-Only Manual, Pub. 100-02, Medicare Benefit Policy Manual, Chapter 16, §120 Cosmetic Surgery Sorry, you need to login or register to view additional sections of this Medicare policy. *