These services may or may not be covered by all CoOportunity Health plans. Please see your plan documents for your own coverage information. If there is a difference between this general information and your plan documents, your plan will be used to determine your coverage.
Administrative process
Prior authorization is not required for actinic keratoses treatment.
Coverage
Actinic keratoses treatment is generally covered subject to the indications listed below and per your plan documents.
Indications that are covered
The destruction of actinic keratoses, without restrictions based on lesion or patient characteristics, using surgical or medical treatment methods, including but not limited to:
- cryosurgery with liquid nitrogen
- topical drug therapy
- curettage
- excision
- chemical peels
- dermabrasion
- laser therapy
- Photodynamic therapy (PDT)
Definitions
Actinic keratoses (AKs), also known as solar keratoses, are common, sun-induced pre-cancerous skin lesions that are confined to the epidermis. The lesions typically appear as circumscribed, rough, scaly patches on sun exposed skin, ranging from flesh-colored to reddish-brown. Due to their distinctive roughened quality, AKs may be easier to detect by palpation than visualization (especially in the early stages of development). AKs are usually 1 to 3 mm in diameter, but may be larger in size and may appear in clusters. Although most AKs are asymptomatic, some may exhibit signs and symptoms such as thickening, burning, tenderness, or itching. AKs may progress to squamous cell carcinoma (SCC), a form of skin cancer, or they may spontaneously regress.
Codes
If available, codes are listed below for informational purposes only, and do not guarantee member coverage or provider reimbursement. The list may not be all-inclusive.
This information is for most, but not all, CoOportunity Health plans. Please read your plan documents to see if your plan has limits or will not cover some items. If there is a difference between this general information and your plan documents, your plan documents will be used to determine your coverage.
CoOportunity Health has contracted with HealthPartners Administrators, Inc. to provide claims processing, medical management and certain other administrative services.