Medical billing is a vast domain under which many health areas fall. Though each department’s services and procedures might differ, the billing process is entirely the same, from start to end. All starts with collecting patient information to translate services into codes and ends with submitting claims. Today, we will enlighten the specific domain of dermatology medical billing.
As a healthcare worker, you might know the process of billing. But codes also differ according to the health practice. In terms of dermatology, the billing will go through pre-defined procedures but claims will contain dissimilar codes than other fields.
So here, you will learn about these codes used in dermatology medical billing and some best practices to keep revenue generation optimized.
Common Dermatology Services
Before delving into codes used in this healthcare department, you should learn about the common treatments included in dermatology. This will help you understand the medical procedures of this field, which in turn will make it easy for you to judge when to use which code.
Following are the skin treatments that people receive around the world.
Skin Observation And Consultation
Before conducting any procedure on the skin of the patient, dermatologists first perform a thorough examination of the skin. Patients also discuss their concerns regarding body skin in order to get reliable advice from the professional.
Lesion Removal Procedures
These are the most common and routine tasks of a skin specialist. They spend a lot of their time removing the lesions or dissimilar skin presence of the patient. It may also include benign and malignant growth spots.
Biopsy
In dermatology medical billing, biopsy means to collect a little skin’s portion to conduct a detailed examination. These are just like blood tests, but here the difference is that skin is taken to find out the problem. It helps the specialist find out the rising skin issues and suggest the appropriate treatments.
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Laser Treatments
The application of lasers on skin has been pretty famous these days. This is a quick and effective procedure for treating rising skin diseases including acne and psoriasis. This might also involve the procedures of phototherapy where needed.
Eczema Treatment
Eczema is another skin disease common in many people. Dermatologists use both tropic medication and relevant therapies and procedures to treat this disorder.
Top Dermatology Medical Billing Codes
Now that you have seen what type of services dermatologists provide, let’s dive into the codes category-wise to understand the usage of code at the right time.
Evaluation And Management (E/M) Codes
- 99201 – Office or other outpatient visits for the evaluation and management of a new patient, which requires a problem-focused history and examination.
- 99212 – Office or other outpatient visit for the evaluation and management of an established patient, which requires a problem-focused history and examination.
- 99243 – Office consultation for a new or established patient, which requires a detailed history and examination.
- 99213 – Office or other outpatient visit for the evaluation and management of an established patient, which requires an expanded problem-focused history and examination.
- 99214 – Office or other outpatient visit for the evaluation and management of an established patient, which requires a detailed history and examination.
- 99244 – Office consultation for a new or established patient, which requires a comprehensive history and examination.
Procedure Codes For Skin Lesion Removal
- 11300 – Shave biopsy, single lesion
- 11301 – Shave biopsy, each additional lesion
- 11400 – Excision, benign lesion, face, ears, eyelids, nose, lips; excised diameter over 4.0 cm
- 11401 – Excision, malignant lesion, face, ears, eyelids, nose, lips; excised diameter over 4.0 cm
- 11600 – Excision, malignant lesion, scalp, neck, hands, feet, genitalia; excised diameter over 4.0 cm
- 11601 – Excision, malignant lesion, scalp, neck, hands, feet, genitalia; excised diameter over 4.0 cm; each additional lesion
Biopsy Codes
- 11100 – Biopsy of skin, subcutaneous tissue, and/or mucous membrane (including simple closure), unless otherwise listed; single lesion
- 11101 – Biopsy of skin, subcutaneous tissue, and/or mucous membrane (including simple closure), unless otherwise listed; each separate/additional lesion
- 11102 – Tangential biopsy of skin (e.g., shave, scoop, saucerize, curette); single lesion
- 11103 – Tangential biopsy of skin (e.g., shave, scoop, saucerize, curette); each separate/additional lesion
- 11104 – Punch biopsy of skin (including simple closure); single lesion
- 11105 – Punch biopsy of skin (including simple closure); each separate/additional lesion
Phototherapy And Laser Treatment Codes
- 96910 – Photochemotherapy; psoralens and ultraviolet A (PUVA), one or more exposures, same day
- 96912 – Photochemotherapy; with UVB
- 96920 – Laser treatment for inflammatory skin disease (psoriasis); total area less than 250 sq cm
- 96921 – Laser treatment for inflammatory skin disease (psoriasis); total area greater than or equal to 250 sq cm
- 17110 – Destruction (e.g., laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), premalignant lesions (e.g., actinic keratoses); first lesion
Psoriasis And Eczema Treatment Codes
- J3301 – Triamcinolone acetonide, per 10 mg
- J0178 – Adalimumab, per 10 mg
- J3490 – Unclassified drugs
- S0189 – Injection, ustekinumab, 1 mg
- S0155 – Injection, methotrexate sodium, 5 mg
- G3760 – Psoriasis area and severity index (PASI) assessment
- 97035 – Ultraviolet light therapy (UVB)
Modifier Usage In Dermatology Billing
Besides normal codes, some modifier codes are also used in the dermatology medical billing process. Modifiers refer to some additional codes that provide further clarification on the services received by the patients. These are additional codes that play an important role in claim applications. Here are some common modifiers used in dermatology:
-25
This modifier shows that a separate and necessary E/M service was performed on the patient, on the same day of the main treatment.
-59
This clarifies that a distinct service other than the treatment has been given to the patient on the same day. This modifier is used when multiple procedures are conducted on the same visit.
-58
This number identifies that an anticipated procedure was done on the patient that was decided from the previous or initial operation visit.
-51
When multiple but distinct services are performed on the same day of the visit, dermatologists use this modifier.
-76
When the same skin service was repeated on the patient on the same day, this modifier is used.
-24
This modifier is used when an unrelated E/M service is conducted after the main operation.
-62
When 2 surgeons, mostly one as a skin specialist or the second as an assistant perform a procedure together on a patient, this modifier is used. It indicates that 2 people operated.
Master Dermatology Codes
With these codes used in dermatology medical billing, you can better have an idea of how the billing system works in this department. So whether you are a future biller, or currently in your learning phase, make sure to study all codes used in medical billing and coding and enter the world of billing with accurate code knowledge.