Dermatology Billing And Coding Tips

Latest dermatology billing trends are here in below:

COVID-19 Related Treatments:

In April 2021, dermatology research was presented at the American Academy of Dermatology (AAD) annual meeting held virtually due to the COVID-19 pandemic. The pandemic’s effect on the skin was major topic of the meeting, Throughout the course of the pandemic, mask-wearing increases in acne, erythema, and rhytides cases.

Teledermatology Appointments:

A study presented at the annual AAD conference reflect that post-pandemic, patients prefer teledermatology appointment options. The shift from in-person to virtual visits trend may have lasting effects, even dermatology clincs open now. Dermatology practice must be prepared to navigate the many factors of these digital visits, including patient privacy and cybersecurity, which will impact dermatology billing.

Anti-Aging Practices:

Skin rejuvenation is anticipated rapid growth, due to the rise in beauty consciousness and an overall aging population across the globe. According to the WHO, the global population of those above 60 years of age is anticipated to increase around 2.1 billion by 2050. Treatment for sagging skin, fine lines, wrinkles, dry skin, and other skin conditions will increase significantly.

Dermatology Billing and Coding Tips:

Due to complexities of dermatology billing and coding, there may be billing and coding errors, resulting in denials and even audits. Billing and coding for dermatology must follow multiple procedure rules and it requires detailed reporting and information on procedures performed.

Billing & Coding Modifiers:

1. Centers for Medicare and Medicaid Services (CMS) define the “25” modifier as, “A significant, separately identifiable evaluation and management [E/M] service by the same physician on the same day of the procedure or other service.”

2. “59” Modifier: Most misused modifiers is the “59” modifier, and for this reason, the X-modifiers were issued by CMS as a subset of the “59” modifier. With this modifier, you can unbundle codes so distinct procedures can be billed, and the claim passes Medicare’s edits.

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

Frequently-Used Medical Codes:

  • B07.0 – Plantar wart

  • B07.9 – Viral wart, unspecified

  • B35.3 – Tinea pedis

  • B35.4 – Tinea corporis

  • B35.5 – Tinea imbricata

  • C43.31 – Malignant melanoma of the nose

  • C44.01 – Basal cell carcinoma of skin of the lip

  • D03.30 – Melanoma in situ of unspecified part of the face

  • D48.5 – Neoplasm of uncertain behavior of skin

  • I83.10 – Varicose veins of unspecified lower extremity

  • I87.2 – Venous insufficiency (chronic) (peripheral)

  • L40.0 – Psoriasis vulgaris

  • L40.52 – Psoriatic arthritis mutilans

  • L40.8 – Other psoriasis

  • L81.0 – Postinflammatory hyperpigmentation

  • L81.2 – Freckles

  • L81.9 – Disorder of pigmentation, unspecified

  • L82.1 – Other seborrheic keratosis

  • L90.5 – Scar conditions and fibrosis of skin

  • L90.6 – Striae atrophicae

  • L20.83 – Infantile (acute) (chronic) eczema

  • L20.9 – Atopic dermatitis, unspecified

  • L21.9 – Seborrheic dermatitis, unspecified

  • L30.9 – Dermatitis, unspecified

  • L70.9 – Acne, unspecified

  • L71.9 – Rosacea, unspecified

  • R21 – Rash and other nonspecific skin eruptions

  • Z48.02 – Encounter for removal of sutures


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