Will My Insurance Cover Removal of Skin Tumors and Lesions? by Danielle Z.

I am a medical biller for dermatology and plastic surgery practices. Throughout my experience I have noticed many patients do not know medical insurance will cover the excision of non-malignant (non-cancerous, benign) skin tumors and lesions. These include nevi, moles, birthmarks and other skin defects. In billing thousands of these types of procedures I have never seen it denied by major medical insurance companies.

Why is it continuously covered? Because they are considered high risk for becoming cancerous over time. For this reason, having them removed is considered preventative and medically necessary. Even lesions that are obviously benign can be removed and covered by insurance if there is any redness, itching, tenderness, or irritation. The best part is that you can have it removed by a plastic surgeon.

In my opinion using a plastic surgeon is a no brainer for both malignant and benign skin defects. They can preserve your health and appearance. A plastic surgeon is trained to perform procedures using techniques that result in minimal scarring, and they are thoughtful about preserving appearance.

Whether you have a mole, nevi or other lesion, they are all abnormal tissue and therefore a higher risk of becoming cancer. In most cases, removing these skin defects is a minor procedure done with local anesthesia. It is important to consider having them removed sooner than later to protect your health.

Be sure to have it biopsied and sent to a pathologist. This can be done by removing a small part of the lesion or the entire thing. It is important for a couple reasons. First, you should know if an area is cancerous or pre cancerous, and second, insurance companies will often deny coverage if the lesion is not sent to pathology. Your dermatologist or plastic surgeon can perform the biopsy. When scheduling your appointment with a plastic surgeon, ask whether you need to have it biopsied by your dermatologist before the consultation. Each office can have a different policy.

The last thing to remember is the one thing that is NEVER covered, a scar revision. It is always considered cosmetic. Don’t wait to see a plastic surgeon until the damage has been done. Your health is most important so don’t ignore the skin defect because you are afraid of a scar, and don’t expect there will be no scar. Expect the plastic surgeon to minimize scarring and to truly care about preserving your appearance.

We do not accept insurance of any kind.