Medical Service

Dermatology

DERMATOLOGY

Dermatology is the branch of medicine dealing with Skin.

Unlike other medical specialties, dermatology is multifaceted. Procedures can range from simple cosmetic surgeries to complicated skin grafts and medical billing must reflect this. Dermatologists typically see more patients than the average physician does in other specialties,

Most commonly used dermatology billing codes:

SKIN BIOPSY:

During a skin biopsy, a dermatologist removes skin samples from the surface of the body. The cells sampled will be examined to determine information about certain skin conditions or diseases.

 CPT
 CPT DESCRIPTION
11102 Tangential biopsy of skin; single lesion.
11103 Tangential biopsy of skin; each separate or additional lesion.
11104 Punch biopsy of kin; 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.

LESION REMOVAL:

Lesions, whether benign, premalignant, or malignant, may be removed by any method, including electrosurgery, cryosurgery, laser, or chemical treatment.  If multiple lesions are removed, multiple procedure codes may be used.

 CPT
CPT DESCRIPTION
17000 Destruction of premalignant lesions (eg, actinic keratoses); first lesion.
17003 Destruction of premalignant lesions (eg, actinic keratoses); 2 – 14 lesions.
17110 Destruction of benign lesions other than skin tags or cutaneous vascular proliferative lesions; up to 14 lesions.

MICROGRAPHIC SURGERY

This surgical technique involves the removal of skin cancer. Mohs surgery is usually conducted in several stages, including the removal of tumor tissue and pathologic exam

 CPT
CPT DESCRIPTION
17311 Mohs micrographic technique on head, neck, hands, feet; first stage.
17312 Mohs micrographic technique on head, neck, hands, feet; each additional stage
17313 Mohs micrographic technique on trunk, arms, and legs; first stage
17314 Mohs micrographic technique on trunk, arms, and legs; each additional stage

EXICISION OF LESIONS:

These procedures involve the surgical removal of lesions and the surrounding tissue.

 CPT
CPT DESCRIPTION
11403 Excision, benign lesion including margins; trunk, arms, or legs.
11603 Excision, malignant lesion including margins; trunk, arms, or legs.

WOUND REPAIRS:

Depending on the severity of the repair, wound closures are classified as simple, intermediate, or complex.

CPT
CPT DESCRIPTION
12031 & 12032 Repair; intermediate; wounds of scalp, axillae, trunk and/or extremities (excluding hands and feet).
13120 & 13121 Repair; complex; scalp, arm, and/or legs

PATHOLOGY:

Pathology procedures study skin and tissue at the microscopic cellular level using advanced laboratory tests and equipment.

 CPT
CPT DESCRIPTION
88302 Level IV – surgical pathology, gross & microscopic exam.
88304 Level III – surgical pathology, gross & microscopic exam.
88312 Special stain including interpretation and report.
88341 Immunohistochemistry or immunocytochemistry.
LASER TREATMENT

Laser therapy utilizes different laser wavelengths to treat a variety of skin conditions and cosmetic purposes.

CPT 96920 & 96921 – Laser treatment for inflammatory skin disease.

Modifiers:

Modifier 25

This modifier should only be used along with E/M CPT codes for patients who are already established with the practice. Don’t use it with new patients or along with other dermatology CPT codes.

Modifier 59

The 59 modifier is attached to other dermatology CPT codes to indicate a service or procedure was distinct or separate from others performed on the same day. The recently added Medicare X-modifiers can be used in place of the “59” modifier.

The X-modifiers include:
  • XE – A distinct service provided in a separate encounter
  • XU – A service that’s distinct because it doesn’t usually overlap the main service or it’s unusual
  • XS – A distinct service performed on a separate structure or organ
  • XP – A distinct service that’s performed by another provider
General Dermatology updates 2022:

There will be no sequestration cut in the first quarter of this year, but in the second quarter (from April to June), there will be a 1% sequestration cut in our reimbursement. Then from July through the rest of the year, and through the next decade or so, we will be facing a 2% cut from sequestration.

For additional information, please contact us at +1440-209-5122 or info@aimuph.com