ICD-10 Codes for Skin Tags: An Ultimate Guide

Skin tags may be small and harmless, but when it comes to medical billing , they can cause surprisingly big headaches. Most providers are aware of the prevalence of skin tags—patients request removals every day in primary care and dermatology settings—but not every removal is billable. Payers want to know whether the procedure was medically necessary or purely cosmetic before they approve payment.

And here’s the tricky part: there’s essentially one primary ICD-10 code for skin tags—but you have to use it correctly, and pair it with the right CPT/HCPCS code and documentation, or the claim won’t stand up under review.

This guide breaks down everything providers need to know about ICD-10 coding for skin tags, from diagnosis codes to payer rules to billing workflow.

What Are Skin Tags? (Clinical Context)

Skin tags , or acrochordons, are small, benign growths of skin that often appear in skin folds—neck, eyelids, armpits, groin, and under the breasts. They’re not dangerous, but they can become irritated, bleed, or cause discomfort when rubbed by clothing or jewelry.

• Prevalence: Approximately 46% of adults develop skin tags at some point in their lives.
• Risk Factors: Obesity, diabetes, friction, and family history.
• Treatment: Shave excision, cryotherapy, cautery, or snip removal.

Key point for billing: Removal is typically considered cosmetic unless the tag is bleeding, irritated, inflamed, or obstructing function (like eyelid tags affecting vision).

ICD-10 Codes for Skin Tags

When it comes to billing for skin tags, providers often assume that a single code will suffice. In reality, payers want more context. Was the removal purely cosmetic? Was the skin tag bleeding, painful, or irritated? Did the patient have an underlying condition, such as diabetes, that contributed to its development?

The ICD-10 system enables you to capture that story in a coded form. Using the right combination of codes not only supports medical necessity but also helps reduce denials, especially since most insurers are quick to label skin tag removal as a cosmetic procedure.

Skin Tag (Primary Code)

The primary ICD-10 code for skin tags is L91.8 – Other hypertrophic disorders of skin.

• This is the main ICD-10 code for skin tags (acrochordon).
• Use this when documenting the presence of one or more skin tags.

Provider Tip: Always start with L91.8 as the base diagnosis for skin tag removal claims.

Associated Conditions (When Relevant)

Sometimes, a skin tag causes or is associated with symptoms that warrant medical attention. Adding these codes alongside L91.8 strengthens your claim.

• R23.8 – Other specified skin changes: Useful if the tag is inflamed, irritated, or bleeding.
• L29.9 – Pruritus, unspecified: If the skin tag is itchy or causing discomfort.
• E11.9 – Type 2 diabetes mellitus without complications

If the patient has diabetes, you document a connection between skin tags and the condition.

Example: A diabetic patient presents with multiple inflamed tags in the neck area. Coding both L91.8 and E11.9 provides a stronger justification than coding L91.8 alone.

Encounter Codes (Optional, But Useful in Certain Payers)

Encounter codes are not always required, but they can be helpful in claims processing—especially when removals are cosmetic.

• Z41.1 – Encounter for cosmetic surgery: Use when removal is for cosmetic purposes only and the patient pays out of pocket.
• Z71.89 – Other specified counseling: Useful if you provided counseling about skin tags (risks, cosmetic nature, or treatment options) but did not perform removal that day.

Tip: These codes often come into play when you need to differentiate between covered and non-covered services during an audit.

ICD-10 Codes for Skin Tags: Quick Reference Table

Always code L91.8 for skin tags, then add supporting symptom or condition codes when applicable. This creates a stronger case for medical necessity and helps defend against denials, especially when insurers default to labeling skin tag removal as cosmetic in nature.

Billing Process for Skin Tag Removal

Just like wound care, skin tag billing isn’t only about the diagnosis code; it’s about the whole workflow.

Step 1: Verify Eligibility and Coverage

• Medicare generally does not cover skin tag removal unless it is documented as medically necessary (e.g., bleeding, irritation, recurrent trauma). Cosmetic removal is the patient’s 100% responsibility.
• Medicaid: Policies vary. Some cover removal if medically necessary. Always check the state Medicaid manual.
• Commercial Plans: Many commercial payers follow Medicare’s rule—removal must be medically necessary, not cosmetic. Pre-auth may be required if multiple lesions are removed.

Tip: Inform patients upfront that cosmetic removals are usually self-pay. Many practices set a flat fee for cosmetic skin tag removal.

Step 2: Documentation Requirements

Payers demand detailed notes showing why removal was medically necessary. Your documentation should include:

• Size & location of the skin tag(s).
• Symptoms (pain, bleeding, recurrent trauma, inflammation).
• Functional issues (e.g., eyelid tag affecting vision, groin tag irritating while walking).
• Treatment performed (snip excision, cryotherapy, electrocautery, etc.).
• Patient counseling (explaining the distinction between cosmetic and medically necessary procedures).

Example of strong documentation:

The patient presents with multiple skin tags on the right side of the neck. One tag measuring 0.7 cm is inflamed and bleeds when rubbed by the shirt collar. Snip excision performed under local anesthesia. Removal is medically necessary due to recurrent bleeding and irritation.

Step 3: CPT/HCPCS Codes for Skin Tag Removal

ICD-10 informs the payer of the condition. CPT tells them what you did about it.

Common CPT Codes:

• 11200 – Removal of skin tags, up to 15 lesions
• 11201 – Each additional 10 lesions (add-on code)

Key Rules:

• CPT 11200 includes up to 15 skin tags—you cannot bill it separately for each one.
• If you remove more than 15 tags, report 11200 once and 11201 for each additional 10 tags.

HCPCS Code (Medicare use):

G0247 – Routine foot care (sometimes used in diabetic patients, if associated with other covered foot care services)

Step 4: Claim Submission and Modifiers

• Link ICD-10 L91.8 (skin tag) with CPT 11200/11201.
• If removal is cosmetic and the patient pays, bill the patient directly don’t submit to the payer unless required.
• If medically necessary, use supporting ICD-10 codes for symptoms (e.g., bleeding, pruritus).

Step 5: Reimbursement & Denials

• Medicare: Typically denies unless medical necessity is proven. Payment for CPT 11200 ranges from $60 to $100, depending on the locality.
• Commercial: Often deny unless symptoms are documented. Some require photos for pre-auth.
• Denials: Most common reason = “cosmetic procedure not covered.

Attach medical notes, wound photos (if allowed), and explain the risk of infection/bleeding to prove the necessity.

Payer-Specific Insights

One of the biggest frustrations providers face with skin tag removal is that coverage rules vary wildly by payer. What Medicare considers a “covered service,” Medicaid may treat differently, and commercial insurers often dismiss it as cosmetic.

That’s why understanding payer-specific policies upfront can save you from denials, wasted staff time, and awkward financial conversations with patients.

Let’s break down how the three big payer groups look at skin tag removal:

1. Medicare

Coverage is extremely limited. Medicare doesn’t cover skin tag removal if it’s purely cosmetic.

They will only pay if the skin tag is symptomatic:

• It bleeds when the patient shaves or moves.
• It frequently gets caught on clothing or jewelry.
• It shows signs of infection or irritation.
• It obstructs vision (common for eyelid skin tags).

Documentation is everything. If you don’t explicitly document the symptom, expect a denial. Medicare auditors look for keywords such as “bleeding,” “infected,” “irritated, ” or “obstructive.”

Example: “Patient presents with multiple acrochordons, one located on the right upper eyelid, causing irritation and obstruction of vision.”

This statement supports coverage better than just “skin tag removal”.

2. Medicaid

• Medicaid coverage varies state by state. There is no single national policy.
• Some state Medicaid programs cover multiple lesion removals if they are symptomatic. Others only allow one or two per visit unless prior authorization is obtained.
• Certain states may require providers to submit photos or additional medical records to justify the necessity of the treatment.
• Prior authorization is more common with Medicaid compared to Medicare.

Tip: Always check your state’s Local Coverage Determination (LCD) or policy manual for the most up-to-date information. For example, some states cover removal if skin tags are associated with diabetes complications, while others deny coverage unless there is an active infection.

3. Commercial Insurance

Most commercial payers exclude cosmetic procedures outright, and skin tag removal typically falls into this category.

The only chance of coverage is when you can demonstrate medical necessity—similar to Medicare (e.g., bleeding, infection, or obstruction).

Clear documentation and the correct use of modifiers can help:

• Modifier -59 (Distinct Procedural Service) if removal is separate from an office visit.
• Modifier -25 if you perform an E/M visit on the same day.

Even with strong documentation, many commercial payers will still deny claims unless the removal meets strict criteria.

Best practice: Have patients sign an Advance Beneficiary Notice (ABN)-style waiver (or the commercial equivalent) acknowledging that they may be responsible for charges if the payer denies coverage. This avoids patient disputes later.

Final Thoughts

Skin tag removals may be simple in the clinic, but the billing side is far from simple. The ICD-10 code L91.8 is your go-to diagnosis code, but payers will deny claims unless you clearly document medical necessity. The key is to pair the diagnosis with CPT 11200/11201, support it with symptoms, and be transparent with patients about coverage.

Create a skin tag removal template in your EHR that prompts for:

• Size/location of lesions
• Symptoms (pain, bleeding, irritation)
• Functional impact
• Procedure performed

This ensures every note supports billing and avoids “cosmetic” denials.

Skin Tag Claims Don’t Have to End in Denials

Most payers treat skin tag removal as cosmetic—but with the right skin tag coding and medical necessity documentation, you can protect your revenue.

Medix Revenue Group helps practices code correctly, submit stronger claims, and manage denials before they drain your bottom line.

Whether it’s Medicare, Medicaid, or commercial payers — we know the policies, and we know how to get your claims approved.

Book a Free Consultation with Us Now.