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verify per payer contract Cosmetic exclusion appeals: Include clinical photographs and dermoscopy reports to support necessity D22.4 as secondary diagnosis: When malignancy is ruled out post-excision and pathology returns benign, D22.4 may be applied as the confirmed final diagnosis Practices managing high-volume nevus removal benefit from before-and-after photo documentation as part of a standard pre-excision workflow

(For the record the second thought was Wow, I didnt realise Clowes was such an butt-man, but more on that later.) This thought occurred to me about 10 minutes and 38 pages in when I came across a two-page spread featuring images from Lloyd Llewellyn , Clowes first comic which was affectionately known as LLLL to its cadre of loyal readers