Removal of Skin Lesions - (Items 31356 to 31388)

The excision of warts and seborrheic keratoses attracts benefits on an attendance basis with the exceptions outlined in TN.8.9 of the explanatory notes to this category. Excision of pre-malignant lesions including solar keratoses where clinically indicated are covered by items 31357, 31360, 31362, 31364, 31366, 31368 and 31370. 

The excision of pigmented lesions which are clinically suspicious for melanoma attracts benefits under items 31377, 31378, 31379, 31380, 31381, 31382 or 31383. 

Excision of malignant tumours are covered by items 31356, 31358, 31359, 31361, 31363, 31365, 31367, 31369, 31371 to 31376, 31386, 31387 and 31388.

Items 31386, 31387 and 31388 should be used for very large, fungating skin cancers.

Items 31357, 31360, 31362, 31364, 31366, 31368, 31370, 31377, 31378, 31379, 31380, 31381, 31382 and 31383 require that the specimen be sent for histological examination. Items 31356, 31358, 31359, 31361, 31363, 31365, 31367, 31369, 31371-31376, 31386, 31387 and 31388 also require that a specimen has been sent for histological confirmation of malignancy, and any subsequent specimens are sent for histological examination. Confirmation of malignancy must be received before itemisation of accounts for Medicare benefits purposes, except in the case of items 31377, 31378, 31379, 31380, 31381, 31382 or 31383.

An incomplete surgical excision of a malignant skin lesion with curative intent should be billed as a malignant skin lesion excision item even when further surgery is needed.

Where histological results are available at the time of issuing accounts, the histological diagnosis will decide the appropriate itemisation for excised lesions. If the histological report shows the lesion to be benign, items 31357, 31360, 31362, 31364, 31366, 31368 or 31370 should be used. 

Practitioners should retain copies of histological reports.