Skin closures and reconstructions following skin procedures
This policy variation clarifies how we cover skin closure and complex reconstructions following a skin lesion healthcare service, or Mohs surgery, when performed under local anaesthetic, oral sedation, IV sedation or general anaesthetic.
Skin closure under the skin lesion services benefit
Skin closure is covered under the skin lesion services benefit where the defect is confined to skin and subcutaneous tissue only, regardless of size, location, or complexity of the closure technique.
This includes (but is not limited to) the following procedures:
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Direct or layered closure
- Extensive undermining or tissue mobilisation
- Skin grafts
- Local, regional, advancement, rotation, or transposition flaps
in each case when no deeper anatomical structures are repaired or reconstructed.
Complex reconstruction under the surgical procedures (following skin procedures)
Complex reconstruction performed following a skin lesion healthcare service or Mohs surgery (under local anaesthetic, oral sedation, IV sedation or general anaesthetic), is covered under the surgical procedures benefit, where the reconstruction:
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involves repair, reconstruction, or alteration of anatomical structures beyond the dermis and subcutaneous tissue, or
- affects adjacent organs or functional structures.
In these cases, the service is classified as reconstruction and is not considered a skin lesion healthcare service.
