When services can be administered in various settings, the Company reserves the right to reimburse only those services that are furnished in the most appropriate and cost-effective setting that is appropriate to the member’s medical needs and condition. This decision is based on the member’s current medical condition and any required monitoring or additional services that may coincide with the delivery of this service.
This Medical Policy Bulletin document describes the status of medical technology at the time the document was developed. Since that time, new technology may have emerged or new medical literature may have been published. This Medical Policy Bulletin will be reviewed regularly and be updated as scientific and medical literature becomes available. For more information on how Medical Policy Bulletins are developed, go to the About This Site section of this Medical Policy Web site.
WHEN USED TO REPRESENT TATTOO REMOVAL BY DERMABRASION, LASER, OR SIMPLE EXCISION:
15783, 17999, 96999
Please note: There are no codes that specifically address the removal of traumatic tattoos. This procedure should be coded with the ICD-10 code specific to the injury type and the CPT code that addresses the method of removal (laser, dermabrasion, excision).
H17.10 Central corneal opacity, unspecified eye
H17.11 Central corneal opacity, right eye
H17.12 Central corneal opacity, left eye
H17.13 Central corneal opacity, bilateral
Q83.0 Congenital absence of breast with absent nipple
Q83.2 Absent nipple
T79.8xxA Other early complications of trauma, initial encounter
T79.8xxD Other early complications of trauma, subsequent encounter
T79.8xxS Other early complications of trauma, sequela
T79.9xxA Unspecified early complication of trauma, initial encounter
T79.9xxD Unspecified early complication of trauma, subsequent encounter
T79.9xxS Unspecified early complication of trauma, sequela
Z85.3 Personal history of malignant neoplasm of breast
Z42.1 Encounter for breast reconstruction following mastectomy
Z51.0 Encounter for antineoplastic radiation therapy
Policy: 11.08.04h:Selective Photothermolysis Using Pulsed-Dye Lasers (PDL)
Policy: 11.08.15x:Reconstructive Breast Surgery
Policy: 11.08.25m:Scar Revision