Skin tags, also known as acrochordons, may be aesthetically unappealing unless they are located in a discreet area and do not cause any medical issues. In conditions where they are irritable or bleed, removal is the only chance left to the patients. However, individuals often get these scars cleared away due to cosmetic concerns, and that’s where healthcare insurance specifies whether the diagnosis of skin tags is reimbursable (if medically necessary) or not within the usage of ICD-10 billable or non-billable codes.
For healthcare providers, choosing the right ICD-10 code for skin tag removal can be tricky without the proper identification of what specific code and related category can cover the diagnosis, considering the other relevant codes. Usually, the coding for skin tags comes in the category of L91 codes and is used to document the number and location of tags on different parts of the body. For instance, the code L91.0–Hypertrophic Skin, not elsewhere classified and (used for skin tags in general). Using the most appropriate code can elevate the level of insurance reimbursement for these critical procedures. Moreover, coding accuracy on these diagnoses helps insurance companies confirm the medical necessity of skin tags. In contrast, improper coding for skin tag diagnoses may lead to costly denials and billing disputes.
The role of the ICD-10 Code set is crucial in dermatology, as these universal numbers serve the standardization and classification of skin tags or other skin-related diagnoses, symptoms, and procedures. With an accurate usage of the relevant codes, medical professionals can avoid ambiguity and ensure all parties involved are on the same page, regardless of the location or speciality.
| List of Skin Tag Billable ICD-10 Codes | ||
|---|---|---|
| ICD-10 Code | Skin Tag Location/Condition | Explanation of the Reason |
| L91.8 | Neck | Hypertrophic skin disorders can include ICD-10 Code for skin tag on neck. |
| L91.8 | Irritated | Irritated skin tags fall under “Other hypertrophic disorders of the skin.” |
| L98.8 | Inflamed | Inflamed skin tags can be coded under “Other specified disorders of skin.” |
| D23.9 | Eyelid | Benign neoplasm of skin; covers specific locations, ICD-10 Skin tag eyelid. |
| D23.9 | Face | Benign neoplasm of skin, unspecified, applies to facial skin tags, called, ICD-10 Code for skin tag on face |
| L91.8 | Left Axilla | Hypertrophic skin disorders, such as skin tags, may occur in the axilla. |
| L98.8 | Bleeding | Bleeding skin tags are considered “Other specified disorders of the skin.” |
| K64.4 | Rectal | Residual hemorrhoidal skin tags are often found in the rectal region. |
| L98.8 | Genital | Genital skin tags fall under “Other specified disorders of the skin.” |
| D23.9 | Unspecified | Unclassified benign neoplasm of skin, including unspecified skin tags. |
| L98.8 | Labial | Skin tags on the labia are classified as “Other specified disorders of the skin.” |
| L91.8 | Groin | Hypertrophic disorders include skin tags in the groin area. |
| D23.9 | Back | Benign neoplasm of skin; the back is included under unspecified locations. |
| K64.4 | Perianal | Perianal skin tags are classified under residual hemorrhoidal skin tags. |
| D23.9 | Ear | Benign neoplasm of skin, unspecified, includes locations like the ear. |
| K64.4 | Anus | Residual hemorrhoidal skin tags commonly occur around the anus. |
Follow this crucial guide that offers explanations on common ICD-10 Codes used for skin tag removal in medical coding and billing. Assess which code can be billed or not while choosing the right code from the ICD and CPT coding networks. Ensure all accuracy aspects in the process to get fairly reimbursed from insurance companies while avoiding billing uncertainties.
The Primary Billable ICD-10 Codes for Skin Tags
The ICD-10 (International Classification of Diseases, 10th edition) coding system offers several codes to bill skin tag removals, however, based on the medical necessity rather than cosmetic reasons. There are several valid codes to consider, such as L91.8, for other specified hypertrophic disorders of the skin and L98.8 for other specified disorders of the skin and subcutaneous tissue. Dermatologists in particular and healthcare providers have the availability of these codes to choose from, however, based on the specificity of the diagnosis and if medically necessary. An accurate application will ensure fair rates in reimbursement to cover skin tag removal.
Below is the detailed description of billable ICD-10 codes and billing guidelines for skin tag removal:
L91.8 (Other Hypertrophic Disorders of the Skin)
ICD-10 Code L91.8 – Other Hypertrophic Disorders of the Skin is a general code used for skin tags (acrochordons) when no more specific diagnosis code applies. This code falls under hypertrophic skin conditions, encompassing benign growths like skin tags that result from localized overgrowth of skin tissues. However, providers must note that L91.8 is a more general code. Healthcare providers ensure use a specific ICD code to document the specific skin issue if possible. While L91.8 is a billable code, its use requires clear clinical documentation of the lesion’s nature, location, and medical necessity, particularly if removal is performed.
Billing Guidelines for L91.8:
- Use L91.8 when skin tags are present but don’t qualify for neoplasm codes like D23.x.
- Ensure removal is medically necessary (e.g., irritation, bleeding); cosmetic cases may be denied.
- Report appropriate CPT codes if excision or destruction is performed.
- Always link the diagnosis to symptoms or complications to justify coverage.
D23.9 (Benign Neoplasm of Skin, Unspecified)
ICD-10 Code D23.9 – Benign Neoplasm of Skin, Unspecified is a general code to cover any type of benign skin growth, however, without a more specific location or defined characteristics. This code is appropriate when the lesion has been diagnosed as benign, but the site is not specified or is generalized across multiple areas. Moreover, healthcare providers performing a skin tag diagnosis using the code D23.9 while also doing the removal can charge for both the diagnosis and procedure.
Billing Guidelines for D23.9:
- Use the code D23.9 for submitting claims for skin tag removal that are non-malignant and medically necessary (e.g., due to irritation, bleeding, or risk of infection).
- Document the benign nature of the lesion, such as clinical justification for removal.
- Add another appropriate CPT code (e.g., 11200 for removal of skin tags).
- Clearly mention the number of lesions treated and the method of removal.
- Not to use this code for cosmetic procedures unless medically justified and documented.
L98.8 (Other Specified Disorders of the Skin & Subcutaneous Tissue)
ICD-10 Code L98.8 – Other Specified Disorders of the Skin and Subcutaneous Tissue records skin and soft tissue conditions not specifically classified elsewhere. Although this code isn’t exclusive to skin tags, healthcare providers can apply the code L98.8 when documenting acrochordons (skin tags). However, if they don’t fit neatly under other hypertrophic or neoplasm codes. This code serves as a catch-all for diagnosed skin issues requiring clinical attention but lacking a precise code. Hence, it is necessary to take heed while documenting this code to specify the use of skin tag removal.
Billing Guidelines for L98.8:
- Document correctly the billable code L98.8 for diagnosing skin conditions and their clinical relevance.
- Specify why a more defined code, like L91.8 or D23.x, was not appropriate, especially if audited.
- Document any associated symptoms (e.g., inflammation, repeated trauma) to justify medical necessity.
- Use any other CPT procedure code for excision or destruction to ensure proper claims processing.
K64.4 (Residual Hemorrhoidal Skin Tags)
Healthacre providers use the ICD-10 Code K64.4 – Residual Hemorrhoidal Skin Tags to describe persistent skin tags that remain after the healing of haemorrhoids. Patients with these tags do not feel the pain yet, these may cause discomfort, hygiene issues, or cosmetic concerns. Residual Hemorrhoidal skin tags are found in the anal region and result from previously swollen hemorrhoidal tissue that has since resolved.
Billing Guidelines for K64.4:
- Providers should use the billable code K64.4 when documenting residual skin tags as a result of hemorrhoidal conditions.
- Clinical documentation must support the medical necessity of the removal of these tags, including (due to irritation, hygiene problems, or recurrent inflammation).
- Consider using another CPT codes for lesion or tag removal, such as 46999 (Unlisted procedure, anus), especially if a more specific procedure code is not applicable.
- Providers must clearly indicate symptoms or complications justifying the intervention.
- For Medicare and many commercial payers, include supporting notes detailing symptoms (e.g., itching, hygiene difficulties, bleeding) and prior treatments attempted.
ICD-10 Non-billable Codes for Skin Tags
In the field of medical coding, there are also codes for skin tags, but they aren’t reimbursable due to the lack of medical necessity. Several ICD-10 Code for skin tag unspecified indicates that the codes are asymptomatic and do not cause medical issues. However, these are used for documentation purposes, such as for quality measurement, public health tracking, research and organizational monitoring in healthcare. Such codes capture certain non-reimbursable documentation activities, including service location or non-claimable activities. As for patients, providers inform them of the cosmetic options for their asymptomatic skin tags, which patients may choose to pay for out of pocket, as they wish. However, using these codes in claims for reimbursement is a serious blunder that results in claims denials or rejection.
Here are some Non-Billable ICD Codes for Skin Tags:
L72.3 – Miliaria Rubra
The ICD-10 Code L72.3 – Miliaria Rubra is a key example considered to be the relevant code to skin tags, but not billable. This code refers to the condition called “prickly heat” or “heat rash” and reflects a small raised bump looking similar to a skin tag at first. It is a type of heat rash that occurs when the sweat glands get blocked. Such conditions happen in hot and humid areas, which cause a lot of sweat. Plus, it results in red, itchy bumps.
The ICD-10 Coding system helps healthcare providers document the diagnosis as each condition, such as Miliaria Rubra, is given a specific code. However, this particular code intends to cover billing and documentation of prickly heat or heat rash. Using this code for skin tags may result in claim denial, as these two conditions are different.
L91.0 – Hypertrophic Scar
ICD-10 Code L91.0 – Hypertrophic Scar is used in medical billing to document skin disorders. This code refers to a scar that is sharply elevated, has an irregular shape, and is enlarged due to excessive collagen production during the healing process. Hypertrophic scars are thick and develop after an injury, burn, surgery, or skin inflammation. With excessive collagen production during the healing process, these cause the scar tissue to get larger than normal. So, these scars look like skin tags but are small, soft, harmless growths hanging from a thin base.
Medical providers should know that L91.0 is not to be used for skin tags as these ars supposed to cover the Hypertrophic scars which are normal part of healing. Using this code to get reimbursed for skin tags will only result in denials, and it is not a billable code for skin tags.
L72.0 – Epidermal Cyst
The ICD-10 Code for Epidermal is a useful one, but healthcare providers cannot use it to indicate skin tag removal in the patient claim form. Healthcare providers may also use this code to refer to skin tags due to the similarity of conditions. Epidermal cyst is a kind of skin cyst filled with ceratin and covered with skin cells. Hence, errors are possible in considering the cyst as skin tags, but using the code L72.0 will not leave a good impression. However, the code can be used for record-keeping rather than billing. Epidermal cysts can develop on any part of the body, but these are not limited to skin tags, hence, L72.0 code would be a non-specific code to document and bill skin tags.
What are the Common Billing & Compliance Considerations?
Proper billing for skin tag removal hinges on distinguishing between cosmetic and medically necessary procedures. Accurate coding, clear documentation, and appropriate use of CPT code for skin tag removal and modifiers are crucial to prevent claim denials, ensure compliance, and avoid costly audits.
- Verify if skin tag removal is medically necessary (e.g., bleeding, irritation); cosmetic removals are typically not covered.
- Document clear symptoms or complications to support the need for removal and ensure payer acceptance.
- Use accurate CPT codes such as 11200 (removal of skin tags, up to 15) and 11201 (each additional 10), when applicable.
- Apply modifiers (e.g., -59 for distinct procedural services) correctly to indicate separate or unrelated services.
- Ensure diagnosis and procedure codes align—mismatches can trigger denials.
- Review payer policies regularly, as coverage criteria for skin tag removal vary widely.
- Keep thorough before-and-after procedure documentation to support medical necessity in case of audits.
- Use real-time coding tools or consult coding experts to reduce claim errors and rejections.
Ensure Effective Coding & Billing Compliance for Skin Tags
Considering the complexities of coding and billing skin tags, outsourcing is always the best option you can take heed on. Proper billing for skin tags hinges on distinguishing between cosmetic and medically necessary procedures. Outsource skin tags medical billing with MedsNexus, which ensures accuracy, clear documentation, and appropriate use of CPT codes and modifiers to prevent denials. Our expert medical billing team is ready to ensure complete compliance through regular audits to stay penalty-free while securing revenue stability.
