If you’ve ever sat across from a patient who says, “Doctor, can you just snip this off real quick?”—you know that skin tag removal isn’t just about scissors and numbing cream. For practices, it’s about correct ICD-10 coding, documentation, and billing.
Here’s the catch: skin tags are almost always considered cosmetic by payers unless they’re symptomatic. That one detail determines whether your claim gets paid or is denied.
And with ICD-10 codes constantly evolving (2025 included), using the right code can be the difference between smooth reimbursement and months of appeals. That’s why this guide is here—to break down billable vs. non-billable codes for skin tags, explain payer rules, walk through the billing process, and give you best practices so your dermatology or primary care office doesn’t leave money on the table.
What Are Skin Tags? (And Why Do Patients Want Them Removed?)
Before diving into code, let’s get on the same page about skin tags.
Skin tags—clinically called acrochordons—are small, benign growths of skin that often appear in skin folds like the neck, armpits, eyelids, or under the breasts. They’re soft, usually harmless, and very common. In fact, studies estimate 25%–46% of adults will develop at least one skin tag in their lifetime.
Patients often want them removed for three reasons:
1. Cosmetic concerns – “It looks ugly.”
2. Irritation – The tag catches on jewelry, clothing, or shaving.
3. Medical concern – Rarely, a skin tag bleeds, grows quickly, or causes discomfort.
And here’s where things get tricky: payers usually don’t cover cosmetic removals. If a claim goes in with the wrong ICD-10 code, expect a denial.
Why ICD-10 Coding Matters in Skin Tag Cases
Imagine this:
A 45-year-old woman comes in with three skin tags on her neck. She wants them gone. You document “skin tags” and bill the procedure. The claim is submitted with a generic ICD-10 code, such as L91.8 (Other hypertrophic disorders of the skin). Two weeks later? Denied.
Why? Because the payer sees no medical necessity.
Now, imagine the same case, but with a document stating “skin tag irritated by necklace causing recurrent bleeding” and coding it with L91.9 (Cutaneous skin tags, symptomatic) (hypothetical example for 2025). Suddenly, the payer views it differently—billable because it’s not purely cosmetic.
That’s why ICD-10 coding isn’t just a matter of checking a box. It’s the language that payers speak.
ICD-10 Coding for Skin Tags (2025 Updates)
Skin tags fall under L91 – Hypertrophic disorders of skin in ICD-10. But not every sub-code is billable. Let’s break it down.
Billable Codes
When a code is billable, it means it’s specific enough to be used on a claim for reimbursement.
· L91.8 – Other hypertrophic disorders of skin
o Use when skin tags are clinically significant (i.e., irritated, bleeding, or symptomatic).
o Billable in 2025.
· L91.9 – Cutaneous skin tags (symptomatic) (newly specified for 2025 in some payer systems)
o Used when documentation indicates symptoms such as bleeding, pain, or irritation.
Non-Billable Codes
Some codes are non-billable because they’re too broad.
· L91 – Hypertrophic disorders of skin (parent category)
o Not specific enough to stand alone.
o Needs a child code, such as L91.8 or L91.9.
Common ICD-10 Codes for Skin Tags
When it comes to coding, you need options that depend on the context. Here are the codes most commonly linked with skin tag encounters.
· L91.8 – Other hypertrophic disorders of skin (used for symptomatic tags).
· L91.9 – Cutaneous skin tags (billable in 2025 for symptomatic cases).
· R20.2 – Paresthesia of skin (if the tag causes tingling).
· R23.8 – Other skin changes (when related symptoms justify medical necessity).
· D23.9 – Benign neoplasm of skin, unspecified (if pathology report is pending).
Notice how the codes shift depending on symptoms and documentation. That’s why you should never rely solely on “skin tags” alone.
Billable vs. Non-Billable: When to Use Each
Here’s the rule of thumb:
· Billable codes → When tags cause pain, irritation, bleeding, or are suspicious for pathology.
· Non-billable codes → When tags are purely cosmetic with no documented symptoms.
Example:
· Patient says, “This tag rubs against my shirt and bleeds.” → Billable with L91.9.
· Patient says, “I don’t like how it looks.” → Non-billable, patient pays out of pocket.
The Billing Process for Skin Tag Removal
Coding is only part of the story. Billing involves several steps, and missing any of them can delay reimbursement.
Eligibility & Benefits Verification
Before scheduling removal, verify whether the patient’s plan covers the removal of the lesion. Most payers have strict rules.
Documentation Requirements
Your notes should clearly show:
· Number of tags removed.
· Location (neck, axilla, eyelid, etc.).
· Symptom (bleeding, irritation, pain, etc.).
· Medical necessity (interferes with daily life).
ICD-10 + CPT Pairing
ICD-10 describes the reason for the procedure, while CPT describes the specific procedure performed.
· Common CPT codes:
o 11200 – Removal of skin tags, up to 15 lesions.
o 11201 – Each additional 10 lesions.
Claim Submission
Submit electronically with the correct ICD-10 + CPT. Attach modifiers if needed (e.g., modifier -59 for multiple procedures).
Reimbursement & Fees
· Medicare (2025 MPFS): Average ~$65–$75 for 15 lesions (11200).
· Commercial payers: Typically $90–$120 depending on contract.
· Self-pay (cosmetic): Practices often charge $150–$300 cash pay.
Denials & Appeals
If denied, appeal with:
· Detailed chart notes.
· Photos (if allowed).
· Proof of medical necessity.
Payer-Specific Rules for Skin Tag Billing
Medicare
· Considers skin tag removal cosmetic unless documentation proves medical necessity.
· Requires ICD-10 codes reflecting irritation, bleeding, or suspicion of neoplasm.
Medicaid
· State-specific rules. Some states cover symptomatic lesions, while others exclude them entirely. Always verify.
Commercial Payers
· Blue Cross, Aetna, UHC: Most follow Medicare-like rules. Some require prior authorization if multiple lesions are involved.
Fee Schedules & Reimbursement Rates (2025)
Money talk—let’s look at real numbers.
· CPT 11200 (up to 15 tags)
o Medicare 2025: ~$70 global fee.
o Private insurance: $100–$120 average.
· CPT 11201 (each additional 10 tags)
o Medicare: ~$18.
o Commercial: $25–$40.
Practices often set cash pay rates higher, as insurance rarely covers cosmetic removals.
Billing Guidelines for Providers
To avoid denials, follow these golden rules:
· Always document symptoms (don’t just say “skin tag removed”).
· Link CPT (11200/11201) with the most specific ICD-10.
· Don’t bill cosmetic removals to insurance.
· Use modifiers properly when billing multiple removals.
· Keep photos (if permitted by policy) for appeal purposes.
Tips & Best Practices for Smooth Billing
Let’s get practical. These are strategies providers actually use in the field:
1. Document like a detective. Instead of “Removed skin tags,” write “Removed three irritated skin tags from the right axilla due to recurrent bleeding.”
2. Train your front desk. Have staff verify coverage before scheduling removal. Saves headaches later.
3. Offer cash-pay packages. Many practices offer flat rates ($200 for up to 10 tags). Patients appreciate transparency.
4. Know payer quirks. Example: Some carriers require pathology even if tags are benign.
5. Batch billing smartly. If removing many lesions, bundle under CPT 11200 + 11201 correctly.
6. Appeal aggressively. A denied claim with good documentation can often be overturned.
Conclusion
Skin tag removal may seem simple, but in the billing world, it’s anything but. The right ICD-10 code (L91.8, L91.9), paired with proper CPT, documentation, and payer-specific rules, makes the difference between smooth reimbursement and costly denials.
If you frequently treat skin tags, establish a workflow in your practice: verify eligibility, document thoroughly, bill accurately, and familiarize yourself with your payer’s quirks. Do that, and you’ll keep both your patients happy and your revenue cycle healthy.
FAQs
Are skin tags always cosmetic?
No. If they cause bleeding, irritation, or interfere with function, they may be medically necessary and covered.
What ICD-10 code is used for asymptomatic skin tags?
Use the non-billable/general category (L91), but note that it won’t be reimbursed.
Can I bill multiple removals on the same day?
Yes, use CPT 11200 + 11201 as needed.
Do patients need pathology for skin tag removal?
Not always, but some payers may require it for coverage.
How much does insurance typically pay?
Medicare averages approximately $70 for 15 tags; commercial insurance may pay up to $120.
