Dermatology Medical Billing and Coding Guide

Dermatology practices face distinct billing and coding issues due to the specialty’s nature. Due to the medical and surgical components of dermatology, dermatology medical billing can be complex and requires an in-depth understanding of dermatological CPT codes, the proper use of modifiers, and other considerations.

Dermatology Medical Billing and Coding Guide

Dermatology firms may streamline their billing procedures and improve their revenue cycle management by following this guide for dermatology billing best practices! Continue reading to learn about the most frequently used dermatology billing codes and tips for accurate medical billing.

Most Common Dermatology Billing Codes

Below are some of the most commonly used dermatology billing codes that dermatology practices utilize. 

  • Skin Biopsy

A dermatologist collects skin samples from the body’s surface during a skin biopsy. The cells collected will be analyzed to learn more about certain skin problems or diseases.

CPT Code 11102

Skin biopsy; tangential biopsy; one lesion.

CPT Code 11103

Skin biopsy; each distinct or extra lesion.

11104 CPT Code

Kin punch biopsy; single lesion.

11105 CPT Code

Skin punch biopsy; each distinct/additional lesion.

CPT Code 11106

Skin biopsy through the incision; one lesion.

11107 CPT Code

Skin biopsy by incision; each distinct/additional lesion.

40490 is a CPT code.

  • Biopsy of the lip.

CPT Code 69100

Biopsy of the external ear.

  • Lesion Removal

Lesions, whether benign, premalignant, or malignant, can be eliminated using a variety of techniques, including electrosurgery, cryosurgery, laser treatment, or chemical treatment. Multiple procedure codes may be utilized if multiple lesions are removed.

17000 CPT Code

Premalignant lesions (e.g., actinic keratoses) are destroyed; this is the initial lesion.

17003 CPT code.

Destruction of premalignant lesions (e.g., actinic keratoses); between two and fourteen lesions.

17110 CPT Code

Up to 14 benign lesions, excluding skin tags and cutaneous vascular proliferative lesions.

  • Mohs Micrographic Surgery

This surgical procedure is used to remove skin cancer. Mohs surgery is often performed in stages, beginning with the excision of tumor tissue and ending with a pathologic analysis.

CPT Code 17311

First stage of Mohs micrographic technique on the head, neck, hands, and feet.

CPT Code 17312

Additional stages of the Mohs micrographic technique on the head, neck, hands, and feet.

CPT Code 17313

The first stage of the Mohs micrographic technique is on the trunk, arms, and legs.

CPT Code 17314

Additional stages of the Mohs micrographic technique on the trunk, arms, and legs.

  • Excisions of Lesions

These techniques entail the surgical excision of lesions and associated tissue.

11403 CPT Code

Excision of benign lesions on the trunk, arms, or legs, including the margins.

CPT Code 11603

Excision of a malignant tumor from the trunk, arms, or legs, including margins.

  • Wound Repairs

Wound closures are classed as simple, intermediate, or complex, depending on the severity of the repair.

Repair; intermediate; wounds of the scalp, axillae, trunk, and/or extremities CPT Codes 12031 & 12032 (excluding hands and feet).

Repair; complex; scalp, arm, and/or legs CPT Codes 13120 & 13121

  • Pathology

Pathology techniques use advanced laboratory tests and technology to examine skin and tissue at the microscopic cellular level.

88305 CPT code.

Surgical pathology, gross and microscopic examinations at level IV.

CPT Code 88304

Level III – gross and microscopic examination of surgical pathology.

CPT Code 88312

Staining procedure with interpretation and report.

88341 CPT code.

Immunohistochemistry or immunocytochemistry are two terms that refer to the same thing.

  • Laser Therapy Treatments

Different laser wavelengths are used in laser therapy to address a variety of skin problems and cosmetic goals.

96920 & 96921 CPT Codes

Laser therapy is used to treat inflammatory skin diseases.

Treatments with Phototherapy

UV light is used in phototherapy to treat skin disorders such as eczema and psoriasis.

96900 CPT code.

Thermotherapy (UV light).

96910 CPT Code

Photochemotherapy with tar or petrolatum with ultraviolet B.

96567 CPT code.

External application of light to remove premalignant and/or malignant lesions is called photodynamic treatment.

J7308 CPT Code

Topical aminolevulinic acid hydrochloride.

  • Evaluation and Management

Dermatology evaluation and management CPT codes are classified broadly into office visits, hospital visits, and consultations.

CPT Code 99203

Detailed visit to an office or another outpatient setting for the evaluation and management of a new patient.

CPT Code 99213

15-minute office or another outpatient visit to evaluate and manage an established patient.

CPT Code 99214

Detailed visit to an office or another outpatient setting for the evaluation and care of an established patient.

Keep Up With Modifier Changes

Modifiers are frequently used in dermatology billing to complicate the billing procedure. To avoid claim delays or denials, it is critical for your dermatology practice to understand how to apply modifiers and to stay current on any modifier rule changes, as regulations are constantly changing. The following are some of the more frequently used dermatological modifiers to be aware of and when to utilize them. 

Modifier 25

This modifier should be used in conjunction with E/M CPT codes only for established patients. It should not be used on new patients or in conjunction with other dermatology CPT codes.

Modifier 59

The 59 modifiers are used in conjunction with other dermatological CPT codes to show that a service or procedure was distinct or distinct from others performed that day. Medicare’s recently added X-modifiers may be used for the “59” modifier.

  • Among the X-modifiers are the following:
  • XE – A unique service delivered during a distinct interaction.
  • XU – A different service that does not typically overlap with the primary service or is uncommon
  • XS – An independent service done on a discrete structure or organ.
  • XP – A distinct service provided by a different provider.

When considering medical billing outsourcing, you must ensure that it is the best option for your dermatology practice. A component of that decision is placing your trust in an expert third-party to handle your medical billing. Because the internal staff must balance the practice’s other operations, an outsourced medical billing firm can often maintain a higher level of consistency and control over the dermatological practice’s finances.

Our dermatology insurance billing services can give you the medical billing expertise your practice needs to grow and thrive in today’s modern medical landscape. Contact us today!