Skin is the largest organ of the human body, and there’s an incredibly long list of diseases and conditions that can affect it. As a result, dermatology medical billing is highly complex and nuanced, often requiring staff to become experts on specific dermatology CPT codes and modifiers, which is no easy task.
To add to the challenge, billing processes often change, codes get updated or retired, and new modifiers get added to the list, which can make it difficult to accurately manage your medical billing. Inaccurate billing leads to more claims being rejected, and time and effort wasted on adjusting claims, which ultimately affects your revenue potential and leads to financial inefficiency.
If you want to try and stay ahead of the claims on your own, it can be very helpful to have a “Cheat Sheet” of frequently useddermatology CPT codesfor your billing department to easily reference while filling in information for insurance providers. There are hundreds of codes but your staff can benefit from having a list of 20 or more of the most commonly used CPT codes. You can use our list below as a guide, and add more as necessary.
Evaluation and Management CPT Codes99203 – Office or other outpatient visit for evaluation and management of new patient, detailed. 99213 – Office or other outpatient visit for evaluation and management of an established patient for 15 minutes.99214 – Office or other outpatient visit for evaluation and management of an established patient, detailed.
Skin Biopsy CPT Codes11102 – Tangential biopsy of skin; single lesion11103 – Tangential biopsy of skin; each separate or additional lesion11104 – Punch biopsy of skin; single lesion11105 – Punch biopsy of skin; each separate/additional lesion11106 – Incisional biopsy of skin; single lesion11107 – Incisional biopsy of skin; each separate/additional lesion40490 – Biopsy of lip69100 – Biopsy of external ear
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Mohs Micrographic Surgery CPT Codes17311 – Mohs micrographic technique on head, neck, hands, feet; first stage17312 – Mohs micrographic technique on head, neck, hands, feet; each additional stage17313 – Mohs micrographic technique on trunk, arms, and legs; first stage17314 – Mohs micrographic technique on trunk, arms, and legs; each additional stage
Excisions of Lesions CPT Codes11403 – Excision, benign lesion including margins; trunk, arms, or legs11603 – Excision, malignant lesion including margins; trunk, arms, or legs
Lesion Removal CPT Codes17000 – Destruction of premalignant lesions (eg, actinic keratoses); first lesion17003 – Destruction of premalignant lesions (eg, actinic keratoses); 2 – 14 lesions17110 – Destruction of benign lesions other than skin tags or cutaneous vascular proliferative lesions; up to 14 lesions.
Wound Repair CPT Codes12031 & 12032 Repair; intermediate; wounds of scalp, axillae, trunk and/or extremities (excluding hands and feet)13120 & 13121 Repair; complex; scalp, arm, and/or legs
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Laser Therapy Treatments CPT Codes12031 & 12032 Repair; intermediate; wounds of scalp, axillae, trunk and/or extremities (excluding hands and feet)13120 & 13121 Repair; complex; scalp, arm, and/or legs
Phototherapy Treatments CPT Codes96900 – Actinotherapy (UV light)96910 – Photochemotherapy; tar and ultraviolet B or petrolatum and ultraviolet B96567 – Photodynamic therapy by external application of light to destroy premalignant and/or malignant lesionsJ7308 – Aminolevulinic acid HCL for topical administration
The above list is by no means exhaustive and will need to be updated as necessary. But a dermatology CPT codes cheat sheet can be a handy tool to help your staff identify the correct codes and apply them properly. It is advisable to also include the most commonly used modifiers in your office, depending on which specific services you commonly provide and specialize in.
Our goal at Derm Care Billing Consultants is to help clients cut through the complexity of dermatology billing and establish the best practices to ensure your codes and modifiers are accurate. Dermatology practices can benefit from outsourcing their billing to a specialist like Derm Care to efficiently manage their medical billing, improve their clean claims rate, and stay abreast of updates to codes and modifiers.
Byoutsourcing your medical billing, dermatologists can focus on their work, instead of getting bogged down with claims and denials. Your billing staff can save time and energy which leads to increased staff satisfaction and productivity; dermatologists can ensure they are meeting compliance standards; patients benefit from efficient and accurate treatment and bill processing; and ultimately your practice will realize its true revenue potential.
Contact us today to learn more about how Derm Care can streamline your billing practices and increase billing efficiency and success.
