Scar Revision with Skin Graft
DESCRIPTION
A scar revision involves the surgical reconstruction of an area of skin that has healed or partially healed. When layers of skin heal, they sometimes contract or deviate from the normal healing process. This deviation may result in pain or the inability of related areas to function normally.
POLICY
A scar revision with a skin graft is considered reconstructive and therefore, considered medically necessary if the medical appropriateness criteria are met. (See Medical Appropriateness below.)
MEDICAL APPROPRIATENESS
A scar revision with a skin graft is considered medically appropriate if any of the following criteria are met:
Scar was caused by significant disease or injury; or
Revising the scar would substantially improve a bodily function; or
Revising the scar would significantly reduce pain associated with the scar.
SOURCES
American Academy of Dermatology. (2006). What is a scar. Retrieved April 17, 2006 from http://www.aad.org/public/Publications/pamphlets/WhatisaScar.htm.
Chen, M. A., & Davidson, T. M. (2005). Scar management: Prevention and treatment strategies. Current Opinion in Otolaryngology, Head and Neck Surgery, 13 (4), 242-427. Abstract retrieved April 17, 2006 from PubMed database.
Drake, L. A., Dinehart, S. M., Farmer, E. R., Goltz, R. W., Graham, G. F., Hordinsky, M. K., et al. (1996). Academy guidelines: Guidelines of care for complex closures, flaps, and grafts. Journal of the American Academy of Dermatology, 34 (4), 703-708.
Lee, K. K., Mehrany, K., & Swanson, N. A. (2005). Surgical revision. Dermatologic Clinics, 23 (1), 141-150.
Moran, M. L. (2001). Management of facial cutaneous defects, Part II. Otolaryngologic Clinics of North America, 34 (4), 1-10.
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EFFECTIVE DATE |
5/25/2006 |
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Policies included in the Medical Policy Manual are not intended to certify coverage availability. They are medical determinations about a particular technology, service, drug, etc. While a policy or technology may be medically necessary, it could be excluded in a member's benefit plan. Please check with the appropriate claims department to determine if the service in question is a covered service under a particular benefit plan. Use of the Medical Policy Manual is not intended to replace independent medical judgment for treatment of individuals. The content on this Web site is not intended to be a substitute for professional medical advice in any way. Always seek the advice of your physician or other qualified health care provider if you have questions regarding a medical condition or treatment.
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