Dermatology Billing Compliance – Understanding the Basics

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• Dermatology Billing Compliance Understanding
  the Basics

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Dermatology Billing Compliance Understanding
the Basics
Dermatology as a healthcare specialty according
to the latest census is ranked as the 10th most
in-demand medical field, due to the aging US
population. However, with such a demand comes
increased salaries, which rose by 13 on average
in 2017-18. This lucrative industry which now
stands at 13 billion employs about 15,000
dermatologists in the country, with much of that
cash coming from out-of-pocket cosmetic
procedures like lip injections and laser hair
removal. While profitable, this specialty has
faced its fair share of distress when it comes to
reimbursement of claims. As recently as 2016, the
CMS issued a number of reimbursement cuts to
common dermatological procedures, like the
complex closures on the face. But, the positive
outcome is the many in the industry believe that
the future of dermatology is steady and that
further cuts are unlikely. With these altering
reimbursement rules, it is crucial for
dermatologists to employ truthful dermatology
billing and coding experts to get the money they
deserve. Incorrect dermatology billing takes
youre your vital time and energy away from your
main job, which is to take care of the patients.
You might even find yourself spending more time
handling the codes than attending the patients.
Even then, you might be leaving money back due to
claims denials or laagering AR days.
Medical Billing Services in Oregon
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Dermatology Billing Compliance Understanding
the Basics

• Dermatology coding basics you ought to get right!
• No one disputes that the services a dermatologist
  provides do not benefit patients. However, there
  are some basic procedures and conditions detected
  by dermatologists that are not considered
  important medical services to preserve function
  or promote improved health.
• Removal of skin tags (CPT 11200 and 11201) is
  usually considered a cosmetic procedure that is
  not covered by many commercial insurers or
  government health plans.
• Remember that a skin tag is a localized benign
  hyperplasia of the skin that presents petite
  threat to the overall health of the patient.
• A professional medical billing and coding experts
  like us can review the patient record to
  recognize when CPT codes 11000 and 11001 are more
  precise based on the acknowledged diagnosis and
  reason for the procedure.
• If a dermatologist submits specimens to a
  laboratory to rule out malignant dermal
  neoplasia, the diagnosis coding will reveal that
  the nature of the tags was in question at the
  time of removal, and that they were submitted to
  a pathologist for confirmation of the disease
  process involved. The procedure performed was
  not a routine skin tag removal, but a biopsy.

Medical Billing Services in Oregon
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Dermatology Billing Compliance Understanding
the Basics

• Keep in mind that the language of CPT is very
  specific. Codes exist for biopsies (11000 and
  11001) and the method of obtaining the involved
  tissue does not affect the coding.
• CPT specifies that biopsies can be obtained
  through destruction, shaves, or excision. CPT
  also states that the surgical removal of an
  overall lesion is included in the obtaining of
  biopsy tissue.
• Dermatologists should not bill for an excision
  and a biopsy during the same encounter if the
  same lesion is involved.

Medical Billing Services in Oregon