Dermatology CPT Codes & Tips 2024

July 9, 2024

Dermatology CPT Codes & Tips 2024

Dermatology practices rely heavily on accurate coding for billing and insurance purposes – it’s your livelihood! 

Knowing the right CPT (Current Procedural Terminology) codes is a must for efficient and accurate claims processing…

In this article, we provide you with a detailed resource of common and popular dermatology CPT codes that can help you streamline your practice’s billing processes, along with some tips for dermatology billing.

What are CPT Codes?

CPT codes are numerical codes used to describe medical, surgical, and diagnostic services accurately. 

They are maintained by the American Medical Association (AMA) and are widely used by healthcare providers to report medical procedures and services for billing purposes.

Importance of Accurate CPT Coding in Dermatology

Accurate CPT coding is important in dermatology for several reasons:

  • Ensures proper reimbursement from insurance companies
  • Reduces the risk of claim denials
  • Enhances practice efficiency and revenue cycle management
  • Improves patient satisfaction through clear billing

Using accurate dermatology CPT codes is the foundation for optimized dermatology revenue cycle management

Correct codes, backed by proper documentation, increase the likelihood of claims being accepted on the first submission, which can reduce the time and cost associated with reworking rejected claims by a lot.

Common & Popular Dermatology CPT Codes

 1. Evaluation and Management (E/M) Codes

  • 99201-99205: New patient CPT codes for office or other outpatient visits
  • 99211-99215: Established patient office or other outpatient visits
  • Time-based codes: 99202 (15-29 minutes), 99203 (30-44 minutes), 99204 (45-59 minutes), 99205 (60-74 minutes)
  • Complexity-based codes: 99212 (straightforward), 99213 (low complexity), 99214 (moderate complexity), 99215 (high complexity)

 2. Biopsy Codes for Dermatologists

  • 11102: Tangential biopsy of skin; single lesion
  • 11103: Tangential biopsy of skin; each separate/additional lesion
  • 11104: Punch biopsy of skin; single lesion
  • 11105: Punch biopsy of skin; each separate/additional lesion
  • 11106: Incisional biopsy of skin; single lesion
  • 11107: Incisional biopsy of skin; each separate/additional lesion
  • 40490: Biopsy of lip
  • 69100: Biopsy of external ear

 3. Destruction/Lesion Removal Dermatology CPT Codes

  • 17000: Destruction (e.g., laser surgery, electrosurgery, cryosurgery, chemosurgery) of benign or premalignant lesions; first lesion
  • 17003: Destruction of premalignant lesions (e.g., actinic keratoses); 2 – 14 lesions
  • 17004: Destruction of premalignant lesions (e.g., actinic keratoses); 15 or more lesions
  • 17110: Destruction of benign lesions other than skin tags or cutaneous vascular proliferative lesions; up to 14 lesions

 4. Excision Codes

  • 11403: Excision of benign lesions (e.g., epidermal cysts, sebaceous cysts) including margins, except skin tags; trunk, arms, or legs
  • 11603: Excision of malignant lesions (e.g., basal cell carcinoma, squamous cell carcinoma) including margins; trunk, arms, or legs

 5. Mohs Surgery Codes

  • 17311: Mohs micrographic technique, including removal of all gross tumor, surgical excision, and repair; first stage, up to 5 tissue blocks on head, neck, hands, feet
  • 17312: Each additional stage after the first stage, up to 5 tissue blocks
  • 17313: Mohs micrographic technique on trunk, arms, and legs; first stage
  • 17314: Mohs micrographic technique on trunk, arms, and legs; each additional stage

 6. Pathology Dermatology CPT Codes

  • 88304: Level III – surgical pathology, gross & microscopic exam
  • 88305: Level IV – surgical pathology, gross & microscopic exam
  • 88312: Special stain including interpretation and report
  • 88341: Immunohistochemistry or immunocytochemistry

 7. Laser Therapy and Phototherapy Treatments Cpdes

  • 96920 and 96921: Laser treatment for inflammatory skin disease
  • 96900: Actinotherapy (UV light)
  • 96910: Photochemotherapy; tar and ultraviolet B or petrolatum and ultraviolet B
  • 96567: Photodynamic therapy by external application of light to destroy premalignant and/or malignant lesions
  • J7308: Aminolevulinic acid HCL for topical administration

Tips for Dermatologist CPT Codes

Here are a couple tips to make sure you get the most out of dermatology CPT codes:

Stay Updated with AMA Guidelines

Always verify the latest CPT code updates from the American Medical Association (AMA) to ensure you are using the most current codes. 

Regularly review any changes or additions to the CPT code set.

Keep Detailed Documentation

Make sure that your documentation thoroughly supports the CPT codes used. 

Accurate and detailed records can prevent claim denials and support the medical necessity of the procedures performed.

Use Specific & Accurate Codes

Use specific codes that accurately reflect the procedures performed. 

Avoid using generalized codes when a more precise code is available, as this can improve the accuracy of billing and reduce the risk of audits.

Regular Coding Audits

Conduct regular coding audits to ensure accuracy and compliance. 

Audits can help identify common coding errors and provide an opportunity to educate your staff on proper coding practices.

Train Your Staff

Invest in continuous education and training for your staff

Keeping your team updated on the latest coding practices and changes in CPT codes can enhance the overall efficiency and accuracy of your billing process.

Leverage Technology

Utilize coding software and electronic health records (EHR) systems that are updated with the latest CPT codes. 

Technology can assist in reducing manual errors and streamlining the coding process.

Understand Payer Policies

Familiarize yourself with the policies of different insurance payers. 

Some payers may have specific requirements or preferred codes for certain procedures, which can affect reimbursement.

Clear Communication

Ensure clear communication with your billing team and providers. 

Accurate coding often requires collaboration between clinicians and billing staff to capture the full scope of services provided.

Monitor Denials & Rejections

Regularly monitor and analyze claim denials and rejections. 

Understanding the reasons behind denied claims can help you adjust your coding practices and improve your overall billing accuracy.

By implementing these tips, dermatologists can improve their coding accuracy, ensure proper reimbursement, and streamline their dermatology revenue cycle management

Upgrade Your Dermatology Billing with The Auctus Group

At The Auctus Group, we specialize in optimizing dermatology billing processes to enhance your practice’s revenue cycle management

Our team of experts provides comprehensive support in CPT coding, ensuring accuracy and compliance with the latest AMA guidelines. 

By partnering with us, you can expect:

  • Customized Solutions: Tailored strategies to meet your specific billing needs.
  • Expert Training: Ongoing education for your staff on the latest coding practices.
  • Advanced Technology: State-of-the-art billing software to streamline processes.
  • Audit Services: Regular audits to identify and correct coding errors, ensuring maximum reimbursement.

Maximize your practice’s efficiency and profitability with The Auctus Group today!

Conclusion

Staying informed about the correct dermatology CPT codes is key for the financial health of your practice. 

Accurate coding not only ensures proper reimbursement, but also helps in maintaining compliance with billing regulations. 

Check out our skin check ICD-10 codes for another great cheat sheet, or contact us for medical billing outsourcing/boosting your practice!

For further assistance or consultation on dermatology billing and coding, just give us a call or send us a message!

FAQs

Is dermatology billing hard?

Dermatology billing can be complex due to the variety of procedures and services provided. Accurate coding and thorough documentation are essential to avoid claim denials and ensure proper reimbursement.

What is the billing code for dermatology visits?

The billing codes for dermatology visits are typically found in the Evaluation and Management (E/M) category, such as 99201-99205 for new patients and 99211-99215 for established patients.

What is the most common modifier we use in dermatology?

One of the most common modifiers used in dermatology is the 25 modifier, which indicates a significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure or other service.

What is the 24 modifier in dermatology?

The 24 modifier is used to indicate an unrelated evaluation and management service by the same physician during a postoperative period.

What is the 57 modifier for dermatology?

The 57 modifier is used to indicate an evaluation and management service that resulted in the initial decision to perform surgery.

What is the 51 modifier for dermatology?

The 51 modifier indicates multiple procedures performed during the same surgical session. It is used to denote that more than one procedure was performed and reduce the payment for secondary procedures.

What is the 59 modifier in dermatology?

The 59 modifier is used to indicate a distinct procedural service. It is used when procedures that are not normally reported together are performed during the same session but are distinct and independent of each other.

What is the 79 modifier for dermatology?

The 79 modifier is used to indicate an unrelated procedure or service by the same physician during the postoperative period.

What is the XS modifier for dermatology?

The XS modifier indicates a separate structure and is used to denote that a service is distinct because it was performed on a different structure or organ system.

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