Are your dermatology billing practices optimized for the final quarter, or are you leaving money on the table? As we approach year-end, the pressure rises to recover old Accounts Receivable (AR) while maintaining smooth billing operations.
Nearly 15% of medical claims are initially denied––contributing to a growing AR balance that can cripple your practice’s cash flow. The final quarter is your last chance to reclaim lost revenue and set your practice on a solid financial footing for the New Year. Don’t worry! Here are some proven strategies to enhance your dermatology billing process, recover aging AR, and secure your practice’s financial health.
Hidden Challenges Behind Dermatology Billing and Coding:
Dermatology billing is not just about coding and submitting claims; it involves navigating a complex web of procedures, payer requirements, and ever-changing regulations. Dermatology practices deal with various services, from cosmetic procedures to skin biopsies, each requiring precise coding. Mistakes in coding, especially in procedures involving multiple treatments, can lead to claim denials and delayed payments––which then contribute to old AR.
Common Dermatology CPT Codes:
- CPT 11100: Biopsy of skin, subcutaneous tissue, or mucous membrane; single lesion.
- CPT 17000: Destruction (e.g., laser surgery, electrosurgery, cryosurgery, chemosurgery) of premalignant lesions (e.g., actinic keratosis); first lesion.
- CPT 99213: Office or other outpatient visit for the evaluation and management of an established patient, typically requiring a detailed history and examination.
- CPT 12001: Simple repair of superficial wounds of neck, scalp, external genitalia, axillae, trunk, and/or extremities (including hands and feet); 2.5 cm or less.
- CPT 11400: CPT 11400: Excision of a benign lesion, including surrounding margins, on the trunk, arms, or legs, with the excised lesion having a diameter of 0.5 cm or less. This excludes the removal of skin tags unless specified elsewhere.
Key 2024 Dermatology CPT Updates and Billing Changes:
The 2024 Dermatology CPT updates bring several important changes, including 349 overall modifications—225 new codes, 75 deletions, and 93 revisions. Though dermatology sees only minor adjustments, staying informed is essential for accurate billing. Key updates include:
- Direct Supervision Extension: CMS has extended the waiver for Direct Supervision via audio-visual means for incident-to services for Medicare patients until December 31, 2024. Dermatologists should confirm these updates with commercial carriers.
- Conversion Factor and Billing Changes: The 2024 conversion factor is $32.74, impacting billing practices. Notably, billing for prolonged service codes (99417/99418) now requires an additional full 15 minutes beyond the base time.
5 Proven Strategies for Effective Old AR Recovery in Dermatology Billing and Coding
- Conduct a Comprehensive AR Audit:
Begin with a detailed audit of your AR to identify the most problematic claims. By categorizing claims based on their age and the reasons for denial, you can prioritize which ones to tackle first. Studies show that nearly 90% of denials are preventable or recoverable, making a thorough review essential. - Enhance Documentation Practices:
Ensure that all procedures are documented with precision. Incomplete or unclear documentation is one of the leading causes of claim denials. Training your staff to maintain meticulous records can prevent future denials and make it easier to appeal the existing ones. - Leverage Advanced Billing Software:
Utilize billing software with claim-scrubbing capabilities. These tools can catch errors before claims are submitted, reducing the likelihood of denials and the accumulation of old AR. Additionally, software that integrates real-time eligibility verification can prevent eligibility-related denials before they occur. - Implement a Robust Denial Management Process:
A structured denial management process is crucial for smooth billing processes. This includes timely follow-ups, identifying patterns in denials, and making necessary adjustments to billing processes. By continuously refining your approach, you can reduce the incidence of future denials and improve your recovery rate on old claims. - Outsource AR Management:
Consider outsourcing your old AR management to a specialized revenue cycle management (RCM) provider. Experts in dermatology billing can navigate the complexities of AR recovery more efficiently––freeing up your staff to focus on patient care.
Partner with MBC: Your Key to Streamlining Dermatology Billing and Coding
Managing dermatology billing and coding on your own can be overwhelming due to its complex coding requirements and ever-changing regulations. Medical Billers and Coders (MBC) specializes in streamlining revenue cycle management for dermatology practices, ensuring compliance and maximizing reimbursements.
By outsourcing your Dermatology Billing and Coding to MBC, you can:
- Optimize Revenue: Benefit from improved reimbursement rates and reduced AR days.
- Focus on Patient Care: Shift your focus from complex billing tasks to providing excellent patient care.
- Enhance Compliance and Accuracy: Stay ahead of coding changes and reduce claim rejections with MBC’s expertise.
- Cost-Effective Solutions: Outsourcing to MBC can be more cost-effective than maintaining an in-house billing team, potentially boosting your revenue by 10-15%.
Don’t Let Financial Challenges Hold You Back!
Contact MBC today to enhance your dermatology billing efficiency and improve your financial performance.
FAQs:
Q: What are common reasons for claim denials in dermatology billing and coding?
A: Common reasons include coding errors, missing or incomplete documentation, and services not covered by the patient’s insurance.
Q: How can I improve the accuracy of my dermatology billing and coding?
A: Regular staff training on the latest coding guidelines, detailed documentation, and using advanced billing software can significantly improve billing accuracy.
Q: What causes claim denials in dermatology billing?
A: Claim denials in dermatology billing often result from coding errors, incomplete documentation, or services not covered by the patient’s insurance plan.
Q: How can I recover old Accounts Receivable (AR) in dermatology?
A: Recovering old AR involves conducting a detailed audit, improving documentation practices, using advanced billing software, and implementing a robust denial management process.
Q: What are key dermatology CPT codes for common procedures?
A: Some commonly used dermatology CPT codes include:
- 11100: Biopsy of skin, subcutaneous tissue, or mucous membrane
- 17000: Destruction of premalignant lesions
- 11400: Excision of benign lesions on the trunk, arms, or legs.
Q: How can I reduce dermatology claim denials?
A: Reducing claim denials involves maintaining precise documentation, training staff regularly on coding updates, and using billing software to prevent errors.
Q: What billing changes should dermatology practices expect in 2024?
A: Key 2024 changes include updates to the CPT codes, the extension of CMS’s waiver for Direct Supervision via audio-visual means, and adjustments to the conversion factor impacting billing practices.
Q: How can outsourcing dermatology billing improve my practice’s cash flow?
A: Outsourcing dermatology billing to a specialized provider like Medical Billers and Coders (MBC) can optimize reimbursements, reduce AR, and allow your team to focus on patient care while ensuring compliance with the latest billing regulations.
Q: How does CMS guide the management of old Accounts Receivable (AR) in dermatology practices?
A: Centers for Medicare & Medicaid Services (CMS) guidelines emphasize timely filing of claims within 12 months, accurate documentation and coding to prevent denials, and the use of the Medicare appeals process for recovering denied claims. Additionally, adherence to National Correct Coding Initiative (NCCI) edits is crucial to avoid denials and manage old AR effectively.
