23 Miss. Code. R. 203-4.19

Current through December 10, 2024

Rule 23-203-4.19 - Skin Tag Removal

A. Medicaid does not cover removal of benign skin tags that do not pose a threat to health or function.

B. Medicaid covers the removal of skin tags when there is medical documentation that one or more of the following conditions exist:

1. The skin tag has one or more of the following characteristics: bleeding, itching, pain,

2. The skin tag has physical evidence of inflammation such as purulence, oozing, edema, erythema,

3. The skin tag obstructs an orifice,

4. The skin tag clinically restricts vision,

5. There is clinical uncertainty as to the likely diagnosis, particularly where malignancy is a realistic consideration based on the skin tag appearance, or

6. A prior biopsy suggests or is indicative of malignancy.

C. Medicaid requires documentation to include the patient's signs and symptoms and skin tag physical findings including size, location, appearance, number, duration and changes over time, tissue diagnosis report, operative note with detail to support the surgical procedure performed.

23 Miss. Code. R. 203-4.19

Miss. Code Ann. § 43-13-121