Home

Blog

Decoding Dermatology Billing: Simplifying the Complexities

Estimated Read Time: 5 mins

Rate:

Dermatology plays a vital role in diagnosing and treating various skin conditions, making it an essential field of medicine. However, navigating the intricacies of dermatology billing can be challenging for both practitioners and medical billing professionals. In this blog post, we will delve into the world of dermatology billing, exploring key concepts and providing insights to help streamline the billing process.

Understanding CPT Codes in Urgent Care Billing: Accurate coding is crucial in dermatology billing as it ensures proper reimbursement for services provided. The Current Procedural Terminology (CPT) codes, along with International Classification of Diseases (ICD) codes, form the backbone of dermatology coding. Here are some key coding categories in dermatology:

Evaluation and Management (E/M) Codes: E/M codes are used to document and bill for patient encounters, including office visits. These codes range from simple consultations to complex evaluations, reflecting the level of medical decision-making and the intensity of the service provided.

Lesion Excision and Removal: Dermatologists frequently perform procedures such as excisions, removals, or biopsies of skin lesions. Specific CPT codes are used to identify and bill for these procedures based on factors like the size, location, and complexity of the lesion.

Biopsies and Pathology: When a dermatologist performs a biopsy to evaluate a skin condition further, specific CPT codes are assigned. Additionally, pathology reports provide additional information about the biopsy, including the diagnosis, and are also coded accordingly.

Skin Allergy Testing: Dermatology practices often conduct skin allergy testing to identify allergens causing adverse reactions. CPT codes exist to represent different methods of testing, such as prick tests, patch tests, or intradermal tests.

Commonly used CPT codes for dermatology:

Evaluation and Management (E/M) Codes:

99213: Established patient office visit, 20-29 minutes.

99202: Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and low level of medical decision making.

Skin biopsy: Skin biopsy is a common procedure in dermatology, and the following are some of the most commonly used CPT codes for skin biopsy

11102: Tangential biopsy of skin; single lesion.

11103: Tangential biopsy of skin; each separate or additional lesion.

11104: Punch biopsy of skin; single lesion.

11105: Punch biopsy of skin; each separate or additional lesion.

11106: Incisional biopsy of skin; single lesion

11107: Incisional biopsy of skin; each separate or additional lesion.

40490: Biopsy of lip.

69100: Biopsy of external ear.

67810: Biopsy of eyelid margin.

54100, 57100, 56605 or 56606: Biopsy codes for genitalia

Excision: Excision is another common procedure in dermatology, and the following are some of the most commonly used CPT codes for excision:

11400: Excision, benign lesion, except skin tag (unless listed elsewhere), trunk, arms or legs; lesion diameter 0.5 cm or less.

11401: Excision, benign lesion, except skin tag (unless listed elsewhere), trunk, arms or legs; lesion diameter 0.6 to 1.0 cm.

11402: Excision, benign lesion, except skin tag (unless listed elsewhere), trunk, arms or legs; lesion diameter 1.1 to 2.0 cm.

11403: Excision, benign lesion, except skin tag (unless listed elsewhere), trunk, arms or legs; lesion diameter 2.1 to 3.0 cm.

11404: Excision, benign lesion, except skin tag (unless listed elsewhere), trunk, arms or legs; lesion diameter 3.1 to 4.0 cm.

11401: Excision, benign lesion, except skin tag (unless listed elsewhere), trunk, arms or legs; lesion diameter 0.6 to 1.0 cm.

11406: Excision, benign lesion, except skin tag (unless listed elsewhere), scalp, neck, hands, feet, genitalia; lesion diameter 0.5 cm or less.

11420: Excision, benign lesion, except skin tag (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous membrane; lesion diameter 0.5 cm or less.

11421: Excision, benign lesion, except skin tag (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous membrane; lesion diameter 0.6 to 1.0 cm.

11420: Excision, benign lesion, except skin tag (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous membrane; lesion diameter 0.5 cm or less.

11422: Excision, benign lesion, except skin tag (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous membrane; lesion diameter 1.1 to 2.0 cm.

11423: Excision, benign lesion, except skin tag (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous membrane; lesion diameter 2.1 to 3.0 cm.

11424: Excision, benign lesion, except skin tag (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous membrane; lesion diameter 3.1 to 4.0 cm

Other procedures: Other commonly used CPT codes in dermatology include:

17000: Destruction (e.g., laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), all benign or premalignant lesions (except actinic keratoses); up to 14 lesions.

17003: Destruction (e.g., laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), all benign or premalignant lesions (except actinic keratoses); 15 or more lesions.

17110: Destruction (e.g., laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), of benign lesions other than skin tags or cutaneous vascular proliferative lesions; up to 14 lesions.

17111: Destruction (e.g., laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), of benign lesions other than skin tags or cutaneous vascular proliferative lesions; 15 or more lesions.

15788-15793: Chemical peel.

10040-10061: Acne surgery.96900-96912

95004: Percutaneous tests (scratch, puncture, prick) with allergenic extracts, immediate type reaction, including test interpretation and report.

Photochemotherapy (Goeckerman or PUVA) for severe photoresponsive dermatoses; first 30 minutes through each subsequent 30 minutes of direct patient contact

It is important to note that the selection of the appropriate CPT code depends on several factors, including the type of service provided, the level of care required, and the technique used.

“Ready to optimize your healthcare practice’s revenue cycle? Discover how RCM Works can streamline your billing processes and enhance financial efficiency today.”

Comment Form

Decoding Dermatology Billing: Simplifying the Complexities

16, August 2023

Unraveling the Complexity of Urgent Care Billing: A Guide to CPT Codes and Reimbursements

16, August 2023

Demystifying Dental Billing: Understanding CPT Codes, Reimbursement, and Procedures

16, August 2023

Trending blogs

Decoding Dermatology Billing: Simplifying the Complexities

August 16, 2023

Unraveling the Complexity of Urgent Care Billing: A Guide to CPT Codes and Reimbursements

August 16, 2023

Demystifying Dental Billing: Understanding CPT Codes, Reimbursement, and Procedures

August 16, 2023

MENTAL HEALTH CPT CODES 2022

August 16, 2023

Get in Touch

Get in Touch

Home

Blog

Decoding Dermatology Billing: Simplifying the Complexities

Decoding Dermatology Billing: Simplifying the Complexities

Estimated Read Time: 5 mins

Rate:

Share your Blog

Evaluation and Management (E/M) Codes: E/M codes are used to document and bill for patient encounters, including office visits. These codes range from simple consultations to complex evaluations, reflecting the level of medical decision-making and the intensity of the service provided.

Lesion Excision and Removal: Dermatologists frequently perform procedures such as excisions, removals, or biopsies of skin lesions. Specific CPT codes are used to identify and bill for these procedures based on factors like the size, location, and complexity of the lesion.

Biopsies and Pathology: When a dermatologist performs a biopsy to evaluate a skin condition further, specific CPT codes are assigned. Additionally, pathology reports provide additional information about the biopsy, including the diagnosis, and are also coded accordingly.

Skin Allergy Testing: Dermatology practices often conduct skin allergy testing to identify allergens causing adverse reactions. CPT codes exist to represent different methods of testing, such as prick tests, patch tests, or intradermal tests.

Commonly used CPT codes for dermatology:

Evaluation and Management (E/M) Codes:

99213: Established patient office visit, 20-29 minutes.

99202: Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and low level of medical decision making.

Skin biopsy: Skin biopsy is a common procedure in dermatology, and the following are some of the most commonly used CPT codes for skin biopsy

11102: Tangential biopsy of skin; single lesion.

11103: Tangential biopsy of skin; each separate or additional lesion.

11104: Punch biopsy of skin; single lesion.

11105: Punch biopsy of skin; each separate or additional lesion.

11106: Incisional biopsy of skin; single lesion

11107: Incisional biopsy of skin; each separate or additional lesion.

40490: Biopsy of lip.

40490: Biopsy of lip.

69100: Biopsy of external ear.

67810: Biopsy of eyelid margin.

54100, 57100, 56605 or 56606: Biopsy codes for genitalia

Excision: Excision is another common procedure in dermatology, and the following are some of the most commonly used CPT codes for excision:

11400: Excision, benign lesion, except skin tag (unless listed elsewhere), trunk, arms or legs; lesion diameter 0.5 cm or less.

11401: Excision, benign lesion, except skin tag (unless listed elsewhere), trunk, arms or legs; lesion diameter 0.6 to 1.0 cm.

11402: Excision, benign lesion, except skin tag (unless listed elsewhere), trunk, arms or legs; lesion diameter 1.1 to 2.0 cm.

11403: Excision, benign lesion, except skin tag (unless listed elsewhere), trunk, arms or legs; lesion diameter 2.1 to 3.0 cm.

11404: Excision, benign lesion, except skin tag (unless listed elsewhere), trunk, arms or legs; lesion diameter 3.1 to 4.0 cm.

11401: Excision, benign lesion, except skin tag (unless listed elsewhere), trunk, arms or legs; lesion diameter 0.6 to 1.0 cm.

11406: Excision, benign lesion, except skin tag (unless listed elsewhere), scalp, neck, hands, feet, genitalia; lesion diameter 0.5 cm or less.

11420: Excision, benign lesion, except skin tag (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous membrane; lesion diameter 0.5 cm or less.

11421: Excision, benign lesion, except skin tag (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous membrane; lesion diameter 0.6 to 1.0 cm.

11420: Excision, benign lesion, except skin tag (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous membrane; lesion diameter 0.5 cm or less.

11422: Excision, benign lesion, except skin tag (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous membrane; lesion diameter 1.1 to 2.0 cm.

11423: Excision, benign lesion, except skin tag (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous membrane; lesion diameter 2.1 to 3.0 cm.

11424: Excision, benign lesion, except skin tag (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous membrane; lesion diameter 3.1 to 4.0 cm

Other procedures: Other commonly used CPT codes in dermatology include:

17000: Destruction (e.g., laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), all benign or premalignant lesions (except actinic keratoses); up to 14 lesions.

17003: Destruction (e.g., laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), all benign or premalignant lesions (except actinic keratoses); 15 or more lesions.

17110: Destruction (e.g., laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), of benign lesions other than skin tags or cutaneous vascular proliferative lesions; up to 14 lesions.

17111: Destruction (e.g., laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), of benign lesions other than skin tags or cutaneous vascular proliferative lesions; 15 or more lesions.

15788-15793: Chemical peel.

10040-10061: Acne surgery.96900-96912

95004: Percutaneous tests (scratch, puncture, prick) with allergenic extracts, immediate type reaction, including test interpretation and report.

Photochemotherapy (Goeckerman or PUVA) for severe photoresponsive dermatoses; first 30 minutes through each subsequent 30 minutes of direct patient contact

It is important to note that the selection of the appropriate CPT code depends on several factors, including the type of service provided, the level of care required, and the technique used.

“Ready to optimize your healthcare practice’s revenue cycle? Discover how RCM Works can streamline your billing processes and enhance financial efficiency today.”

Comment Form

Leave a Comment Cancel Reply

Decoding Dermatology Billing: Simplifying the Complexities

Unraveling the Complexity of Urgent Care Billing: A Guide to CPT Codes and Reimbursements

Demystifying Dental Billing: Understanding CPT Codes, Reimbursement, and Procedures

Trending blogs

Decoding Dermatology Billing: Simplifying the Complexities

Unraveling the Complexity of Urgent Care Billing: A Guide to CPT Codes and Reimbursements

Demystifying Dental Billing: Understanding CPT Codes, Reimbursement, and Procedures

MENTAL HEALTH CPT CODES 2022

Follow Us:

Services

Useful Links

Get in Touch

Our Hours

Copyright © 2024 RCM Works. All Rights Reserved.