Policy Revision - Clinical Coverage Policy 1-O-3, Keloid Excision and Scar Revision

Author: Clinical Policy and Programs

Effective July 1, 2018, North Carolina Medicaid has revised Clinical Coverage Policy (CCP) 1-O-3, Keloid Excision and Scar Revision, to clarify the procedure for proper submission of preoperative photographs to CSRA as part of the prior approval process. The preoperative photographs of keloids or scars should be clearly marked with:

  • Beneficiary’s first and last name
  • Beneficiary’s Medicaid or NCHC identification number
  • Provider’s name and NPI, and,
  • Date the photograph(s) were taken.

After July 1, 2018, providers should refer to CCP 1-O-3, Keloid Excision and Scar Revision, on the Reconstructive Surgery Clinical Coverage Policy web page.

Clinical Policy and Programs
DMA, 919-855-4320

Related Topics: