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TRICARE Policy Manual 6010.63-M, April 2021
Medicine
Chapter 7
Section 17.1
Dermatological Procedures - General
Issue Date:  April 19, 1983
Authority:  32 CFR 199.4(c)(2)(xvi)32 CFR 199.4(c)(2)(xiv)
Copyright:  CPT only © 2006 American Medical Association (or such other date of publication of CPT). All Rights Reserved.
Revision:  C-10, August 14, 2024
1.0  CPT CODES RANGE
17380, 17999, 96567 - 96999
2.0  DESCRIPTION
The diagnosis and treatment of skin disorders.
3.0  POLICY
3.1  Dermatological services may shall be cost-shared for the treatment of a covered condition unless otherwise limited or excluded by this manual.
3.2  Topical treatment for hypertropic scarring and keloids resulting from burns, surgical procedures or traumatic events may shall be cost-shared only if there is evidence of impaired function.
3.3  Medically appropriate treatment for acne is covered.
3.4  Photodynamic therapy and photochemotherapy are payable for treatment of conditions for which the treatment is United States (US) Food and Drug Administration (FDA) approved.
3.5  Medically necessary laser hair removal or electrolysis that primarily corrects or improves a bodily function is covered, whether or not there is also a concomitant improvement in physical appearance. This policy clarification is effective May 6, 2021.
4.0  Exclusions
Services performed for cosmetic purposes such as removal of tattoos, hair removal, removal of telangiectasias, spider angiomas, or facial rejuvenation.
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