Proper, adequate coding and documentation have become an increasingly important aspect of modern medicine, especially with the prevalence of electronic health records (EHR). While electronic records provide some documentation benefits to the physician, such as legibility and ease of inter-physician communication, they also carry potential coding risks.
Many EHR systems automatically calculate the level of service and procedure codes based on physician documentation. This can be convenient but carries the risk of coding incorrectly and potentially reduces the incentive to learn the nuances of coding. Regardless of the coding generated by the EHR or billing staff, the physician is ultimately responsible. Correctly applying modifiers in the Dermatology CPT Code requires a deep understanding of all the components and documentation requirements in codes with global periods.
Dermatology Coding
Dermatology is one of the more complex specialties when it comes to coding and billing. Coders must be familiar with benign and malignant masses, as well as actions such as shaving, destruction, and performing biopsies. In addition, they must identify simple, intermediate, and complex repairs and deal with sizing terms such as length, depth, width, and circumference. And don’t forget to know the difference between centimeters and millimeters.
Dermatologists are adept at providing their coders with the information they need to code correctly, but this may not be true for all other providers. Coders who need to code dermatology-related procedures need to understand each skin condition.
Dermatology CPT Code Updates
- Reflectance Confocal Microscopy has new codes from CPT 96931-96936: RCM Codes 96931, i.e., image acquisition, interpretation, and report, first lesion, 96932 image acquisition only, first lesion, and 96933, i.e., interpretation and report only, first lesion, +96934, i.e. image acquisition, interpretation and report, each additional lesion, +96935, i.e. image acquisition only, each additional lesion, and +96936 (interpretation and report only each additional lesion).
- These codes apply to a free-standing device that produces stacked mosaic images but not to a hand-held confocal device.
- New Category III CPT Codes designated for emerging technology, services, and procedures are temporary numerical codes ending with a T.
- Use CPT 0394T for high-dose-rate electronic brachytherapy, skin surface application, per fraction, and basic dosimetry when performed. Code 0182T for brachytherapy code has been removed.
Procedures with the MelaFind device can be reported using CPT 0400, multi-spectral digital skin lesion analysis to detect melanomas and high-risk melanocytic atypia, one to five lesions. Use CPT 0401T for six or more lesions.
Safeguard Your Dermatology Practice from Costly Coding Mistakes!
Commonly Used Dermatologist CPT Code
Dermatologists employ a range of procedures to address the diverse needs of their patients. Dermatologist CPT codes are used to ensure accurate billing and effective communication among healthcare professionals. Let’s overview commonly used dermatology CPT codes and their associated procedures.
Evaluation and Management (E/M) Codes
Evaluation and management services form an essential part of dermatology practice. These codes document patient encounters, including history-taking, physical examinations, and medical decision-making. E/M codes are categorized based on the complexity and time spent on the evaluation. Commonly used E/M codes in dermatology include:
- 9920-99205: These codes represent the levels of new patient office visits with varying degrees of complexity.
- 99211-99215: These codes represent the levels of established patient office visits.
- 99241-99245: These codes are used for consultations involving another physician evaluating a patient’s condition.
Biopsy and Excision Codes
Dermatologists often perform biopsies and excisions to diagnose and treat skin conditions. The following CPT codes are commonly used in these procedures:
- 11100-11101: These codes are used for the biopsy of skin lesions or tumors, with or without needle aspiration.
- 11102-11107: These codes are used to biopsy each additional lesion during the same encounter.
- 11400-11446: These codes are used for the excision of benign and malignant skin lesions based on the size and complexity of the excision.
Destruction Codes
Destruction procedures involve removing or treating various skin lesions using different methods. The commonly used destruction CPT codes in dermatology include:
- 17000-17004: These codes represent the destruction of benign skin lesions using various techniques such as electrocautery, cryotherapy, or chemical agents.
- 17110-17111: These codes represent the destruction of malignant skin lesions, including basal or squamous cell carcinoma.
Phototherapy Codes
Phototherapy is a commonly employed treatment modality for various skin conditions, particularly those related to photodermatoses and psoriasis. The following CPT codes are used for phototherapy procedures:
- 96900-96999: These codes encompass different types of phototherapy, including ultraviolet (UV) light treatments such as UVB or UVA therapy.
Lesion Removal and Repair Codes
Dermatologists often perform procedures to remove or repair skin lesions resulting from trauma, injury, or surgical excisions. The following CPT codes are used for lesion removal and repair:
- 12001-12057: These codes represent repairing superficial wounds or lacerations.
- 13100-13153: These codes represent complex wound repairs requiring layered closure techniques.
- 14000-14302: These codes represent adjacent tissue transfers or rearrangements for reconstruction after skin tumor removal.
Mohs Micrographic Surgery Codes
Mohs micrographic surgery is a precise technique to remove skin cancers layer by layer while minimizing damage to healthy tissue. The following CPT codes are used for Mohs surgery:
- 17311-17315: These codes represent Mohs surgery for removing various skin tumors, with the number of stages involved.
Dermatology CPT codes are crucial in accurately documenting and billing dermatological procedures. Understanding these dermatologist CPT codes is essential for dermatologists, medical coders, and billing professionals to ensure proper reimbursement and communication within the healthcare system. The codes mentioned in this article represent a subset of commonly used dermatology CPT codes, and many more specific codes are available for various procedures. You are advised to consult a Dermatology Coding Expert for accurate use of dermatology CPT code.
Medical Billers and Coders (MBC) is a leading outsourcing medical billing company that provides complete revenue cycle services. To learn more about our dermatology billing and coding services, email us at info@medicalbillersandcoders.com or call 888-357-3226.
Frequently Asked Questions (FAQs) – Top Dermatology CPT Code Updates
1. What are CPT codes?
CPT (Current Procedural Terminology codes) are medical codes used to report and document medical, surgical, and diagnostic procedures and services. Healthcare providers use them to ensure uniformity and accuracy in medical billing and documentation.
2. Why are there updates to Dermatology CPT codes?
CPT codes are updated annually to reflect advancements in medical technology and changes in clinical practice and to improve clarity and accuracy in coding. These updates help ensure that the billing process accurately represents the services provided to patients.
3. When do the new Dermatology CPT codes take effect?
The updated Dermatology CPT codes typically take effect on January 1st each year. Healthcare providers and billing professionals should be aware of these changes to ensure accurate billing and reimbursement.
4. Where can I find the list of updated Dermatology CPT codes?
The updated CPT codes are in the latest edition of the CPT codebook published by the American Medical Association (AMA). Additionally, updates are often available through professional dermatology associations and coding resources.
5. How do the updates impact dermatology practice billing?
The updates can impact billing by introducing new codes, modifying existing ones, or deleting outdated ones. This may affect reimbursement rates and the way services are documented. Proper training and adjusting the latest codes are crucial for accurate billing practices.
6. Are there specific changes in coding for standard dermatology procedures?
Yes, updates often include changes to coding for standard dermatology procedures such as skin biopsies, excisions, and treatments for skin lesions. Reviewing the specific changes relevant to your practice’s most frequently performed procedures is essential.
7. How can I ensure my practice complies with the new CPT code updates?
To ensure compliance, you should:
- Stay informed by reviewing the updated CPT codebook.
- Attend relevant training sessions and webinars.
- Update your billing software and systems.
- Communicate changes to all relevant staff, including physicians and billing personnel.
8. What should I do if I encounter a discrepancy or issue with a new CPT code?
If you encounter discrepancies or issues with a new CPT code, you should:
- Review the coding guidelines and notes in the CPT codebook.
- Consult with a certified professional coder or billing specialist.
- Reach out to professional dermatology associations or coding support services for guidance.
9. Are resources available to help understand the new Dermatology CPT codes?
Yes, there are various resources available, including:
- The latest CPT codebook from the AMA.
- Professional associations such as the American Academy of Dermatology (AAD).
- Online coding courses and webinars.
- Consultation with certified professional coders.
10. How often should we review and update our knowledge of CPT codes?
Reviewing and updating your knowledge of CPT codes annually when new updates are released is recommended. Regularly attending coding workshops and staying informed about changes throughout the year can also help maintain accurate and efficient billing practices.
