Benign lesion removal (CPT 17110, 11400-11446) is covered only when symptomatic — and the ICD-10 diagnosis, not the procedure, decides whether it pays.

Septoplasty (30520) is covered for functional nasal obstruction, not for a deviated septum on its own. The line is documented obstruction plus failed medical therapy.

Panniculectomy (15830) is covered when the panniculus impairs function. Abdominoplasty is cosmetic. The add-on +15847 is the line where covered claims turn into denials.

CPT 11102, 11104, and 11106 are biopsy primaries by technique. Use multiple techniques in one visit and you still report one primary plus add-ons, not two primaries.

One in five medically necessary breast reductions gets denied, and the number doing the denying is the Schnur scale. Here’s how each payer sets the bar.