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.