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TRICARE Policy Manual 6010.60-M, April 1, 2015
Chapter 7
Section 25.1
Issue Date:  June 19, 2008
Copyright:  CPT only © 2006 American Medical Association (or such other date of publication of CPT). All Rights Reserved.
Early phases of malignant melanoma can be difficult to detect. Surgery (i.e., biopsy) to remove the melanoma is the standard treatment for this disease. However, a number of surveillance technologies have been developed in an attempt to improve accuracy in diagnosing malignancies in pigmented skin lesions without using a biopsy or excision (removal) of the lesion itself.
Dermoscopy (also known as Digital Epiluminescence Microscopy (DELM), dermatoscopy, melanomography, in vivo cutaneous surface microscopy, mole mapping, and magnified oil immersion diascopy) is one of technologies designed for detecting and monitoring dysplastic and atypical nevi for early detection of malignant cutaneous melanomas. The dermoscope allows 10x or higher magnification by using high intensity light. Oil placed between the skin and the lens makes the skin more transparent and enables visualization of skin structures to the bottom of the outermost layer of the skin. This technology offers the physician the ability to have a baseline image to refer to so he or she can examine each suspicious lesion, and then compare them year after year, by re-imaging.
The Dermoscopy technique for diagnosing and monitoring dysplastic and atypical nevi for early detection of malignant cutaneous melanoma in patients with suspicious pigmented skin lesions is not covered because it is considered unproven.
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