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Dermatology Coding Alert

Procedure Coding:
Answer These Questions to Code Lesion Removals Correctly
Always wait on pathology report before deciding on malignancy. Dermatology coders look... Read more
Case Study Corner:
Improve Lesion Removal Smarts with These Scenarios
You might be able to report a separate E/M in some instances. Check out these case stu... Read more
Compliance:
Make Medicare Status Change Before 2017
Remember: Participating providers receive five percent higher fees for services. As th... Read more
Modifiers:
Separate Procedures, Then Make 59/X Decision
Give the payer what it wants — 59 or X. When you have to sort out a claim in whi... Read more
Reader Question:
Mark Depth of Lipoma Before Choosing Code
Question: How would I code for the removal of a mobile lipoma from the right flank ... Read more
Reader Question:
Go with G Modifiers on ABN Claims
Question: When should the dermatology practice get a signed advance beneficiary not... Read more
Reader Question:
I.D. Deep Abscess I&Ds; with This Info
Question: The dermatologist reviews a 29-year-old female patient with complaints of... Read more
You Be the Coder:
Simple, Complicated I & Ds
Question: The dermatologist provides an evaluation and management (E/M) service for... Read more
CCI 22.3:
Tidy Up Your Debridement Coding With These CCI Bundles
Latest edits move several debridement codes into Column 1. Correct Coding Initiative (... Read more
Procedure Coding:
Drain All I&D Coding Doubt With This FAQ
Know what a comedo extractor is? Read on to find out. When your dermatologist performs... Read more
Dual-Provider Coding:
Keep Incident-To, Split Visits Separate With These 3 Tips
Coding decision might be based on POS. Stop me if you’ve heard this one before. ... Read more
Reader Question:
Use 'B' Code for Underlying Infection
Question: An established patient reports to the dermatologist complaining of sores ... Read more
Reader Question:
Start Using This Dx Code for Zika
Question: Is there an ICD-10 code for the Zika virus in the 2017 manual? Massachu... Read more
Reader Question:
Avoid Attention From Medicare By Following Stark Law
Question: I overheard one of our physicians recently tell a nurse practitioners (NP... Read more
You Be the Coder:
Counting Corns and Coding Cutting
Question: A new patient presents to the dermatologist with a chief complaint of cor... Read more
Foreign Body Removal:
Cut to the Chase With This FBR Coding Advice
Here’s what separates an E/M service from an FBR. When your dermatologist perfor... Read more
E/M Coding:
Spot Additional E/M on Some FBR Encounters
Use modifier 25 on E/M when you prove separate service. Let’s say a patient come... Read more
Hospital Coding:
Look Out for Observation Services That Change
Experts: Wait until hospital stay is over before coding. Coders take note: When your ... Read more
Reader Question:
CPT® 2017 Holds T Codes for Neurofibroma Destructions
Question: I have been reading about possible updates to the CPT® manual for 201... Read more
Reader Question:
Get Specific Notes for Complex Closure Claims
Question: Encounter notes specify only that the provider performed “extensive... Read more
Reader Question:
Know Telemedicine Types Before Considering Codes
Question: Often, one of our dermatologists or qualified nonphysician practitioners ... Read more
You Be the Coder:
Coding Open Wounds vs. E/M Services
Question: What is the difference between an open and closed wound, and does open wo... Read more
Pressure Ulcers:
Ease the Pressure of Pressure Ulcer Claims With the Right Dx and Procedure Codes
Tip: Each character of the ICD-10 code makes the diagnosis more specific. Common among... Read more
Laceration Repair:
5 Tips to Stitch Up Your Laceration Repair Coding Errors
Information – particularly location, length, and type of repair – provides t... Read more
Evaluation & Management:
Think a Patient Must Be "Established" Forever? Think Again
These myths could be holding back your dermatology practice’s E/M claims. Whenev... Read more
Reader Question:
Recognize Breach Under HIPAA
  Question: An employee at our dermatology practice accessed records for whi... Read more
You Be the Coder:
Wart Removal from Buccal Sulcus
Question: Our dermatologist recently removed ten lesions of verucca vulgaris from t... Read more
Melanoma:
Stop Melanoma Coding Errors Before They Spread
If the dermatologist gets down to the fascia, would you still stick with an integumentar... Read more
Place of Service Codes:
Know Your Place, and Keep POS Codes in Line
Make sure you’re up to speed on the new and updated codes introduced Jan. 1. Sin... Read more
Practice Management:
5 Steps to Healthier Claims
Learn how common coding mistakes can hurt your practice budget. As the healthcare ind... Read more
Reader Question:
Modifier 78 Helps Dehiscence Pay
Question: Is repair of wound dehiscence ever payable during the global period? If s... Read more
Reader Question:
Don't Get Confused About Diameter for Shaves and Excisions
Question: When our dermatologist performs shaving or excision of a lesion, should w... Read more
Reader Question:
Shave Denials with Modifiers for Multiple Sites
Question: The dermatologist shaved three epidermal lesions that the patient chose n... Read more
You Be the Coder:
Scrotum Biopsy
Question: For a biopsy of the skin of the scrotum, do we report CPT® code 11100... Read more
Sunburn Care:
Keep Your Sunburn Coding in the Pink and Out of the Red
Tip: Know when a sunburn case merits and E/M code. Summer’s just around the corn... Read more
Modifiers:
Make Your CPT® Code Fit the Procedure With the Right Modifier
Some modifiers may look alike, but each has its own distinct purpose – and the dif... Read more
Incident-To:
Dermatologist on Vacation? Make Sure the Sub Meets Incident-To Guidelines
Is your coding office making one of these errors that can wreck your claim? Coders who... Read more
Reader Question:
Work This Plan for SNF Office Payments
Question: One of our dermatologists is treating a skilled nursing facility (SNF) pa... Read more
Reader Question:
Sidestep 'Unprocessable' Denials With These Tips
Question: Due to staff reduction, I have been recruited into doing some coding. I&r... Read more
You Be the Coder:
Cherry Angioma
Question: What would the correct ICD-10 code be for a diagnosis of cherry angioma? ... Read more
ICD-10 Update:
Look for New Hematoma, Redundant Skin Dx Codes
Proposed list would introduce nearly 2,000 new codes, effective Oct. 1. Six months aft... Read more
E/M:
Limited or Complete ROS? The Right Answer Could Yield $100
The number of body systems the dermatologist reviews can boost or lower the E/M code. ... Read more
Debridement:
Don't Just Scrape By With Your Debridement Coding
How deep does the dermatologist go? The answer could change your claim. If you find co... Read more
Fee Schedule:
CMS Tweaks Fee Schedule Conversion Factor
Multiplier is now 2 cents lower than it was at the start of 2016. If you weren’t... Read more
Compliance:
Get Patient Involved in Benefits Fixes
Incorrect insurance info? Check with patient first, say experts. In previous issues of... Read more
Reader Question:
Put Locum Tenens Rules to Work for You Using These Tips
Question: Our practice recently hired a locum tenens (LT) physician to fill in for ... Read more
Reader Question:
Base Coding on HEM, Not Visit Type
Question: I have a provider that saw a patient on Monday and coded a 99214. He then... Read more
You Be the Coder:
Complex or Simple Integumentary Repair?
Question: Would this be considered complex or just a simple repair? Wound repair ... Read more
CCI Update:
Watch for New Confocal Microscopy Bundles
New Correct Coding Initiative edits also touch on adjacent tissue transfers. Dermatolo... Read more
Nail Treatments:
Know Your Options to Report Nail Treatments and Avoid Denials
Key: Distinguish 11730, 11750, and 11765 from routine care. In your practice, you migh... Read more
Practice Management:
Monitor Claims to Max Out Your Dermatologists' Pay
Keep your AR up-to-date. You’re up-to-date on coding changes, you’ve educa... Read more
HIPAA:
Report: Many Practices Are Unprepared for Coming HIPAA Audits
No privacy officer? Then you aren’t HIPAA compliant. As Part B practices nationw... Read more
Reader Question:
Ensure Valid Provider Signatures
Question: I’m having trouble getting my dermatologists to sign their claim fo... Read more
Reader Question:
Make Sure Patients Understand EOB's Purpose
Question: We often get patients who call the practice with questions about their ex... Read more
You Be the Coder:
Pressure Ulcers
Question: A 75-year-old established patient reports to the dermatologist for inspec... Read more
Lesions:
Warts and All, Shave Uncertainty from Your Lesion Coding
Tips: Size – and the number of lesions – matter. Lesion excisions –... Read more
Modifiers:
The 3 Questions You Need to Answer for Modifier 24, 25, and 27 Mastery
Warning: Pick the wrong modifier and leave $100 on the table. Does your dermatologist ... Read more
Revenue:
Knowledge Is Power: Better Info from Patients Can Mean Stronger Billing
Tip: Don’t just ask, “Has your insurance information changed?” We&rs... Read more
Reader Question:
Stick with 12020-12021 for Superficial Wound Dehiscence
Question: Is repair of wound dehiscence ever payable during the global period? If s... Read more
Reader Question:
Correct EHR Entries As You Would Paper
Question: We are aware of how to correct a mistake on a paper medical record, but h... Read more
Reader Question:
Cheat Sheets Are Just a Starting Point
Question: We have been training our new dermatologists to use the superbills we pri... Read more
Reader Question:
Don't Automatically Add 25
Question: Can I charge for a 99213 and a 17250 on the same day at the same visit if... Read more
You Be the Coder:
Microscopic Hair Examination
Question: Is there a code for examination of a hair under a microscope, in cases of... Read more
Dermabrasion:
Smooth Out the Wrinkles in Your Dermabrasion Coding
Many 15780-15783 claims may be cosmetic, but proper coding is still essential to fair re... Read more
Place of Service:
Use New POS Code for "Off-Campus" Dermatology Services
Look for changes in payment coming soon for off-campus provider-based clinics. If your... Read more
Compliance:
Target Your EHRs for Scrutiny
Watch incentive payments, too. HIPAA enforcement just keeps getting tougher — th... Read more
Reader Question:
Count Lesions and Not Number of Injections for Reporting 11900
Question: Our dermatologist recently performed intralesional injections for a patie... Read more
Reader Question:
Use Split Visit Rules to Duck 15 Percent Pay Cut
Question: I’ve heard nurse practitioners (NPs) and other providers talk about... Read more
Reader Question:
NPPs Performing FBRs? Know the Rules
Question: A 44-year-old established patient reported with a splinter lodged in his ... Read more
Reader Question:
Base I&D Follow Up on HEM, Not Visit Type
Question: I have a provider who saw a patient on Monday and coded a 99214. He then ... Read more
You Be the Coder:
Layered Closure After Melanoma Excision
Question: Following a melanoma excision, our dermatologist performed a layered clos... Read more
CCI Update:
Coding Tissue Transfers? Watch for These Changes
New Correct Coding Initiative edits impact which procedures you can report with adjacent... Read more
ICD-10:
Follow These 'Code Also' Guidelines When Reporting Burns
Remember: These ‘x’ characters are merely placeholders. When reporting bur... Read more
E/M:
Make Sure Your E/M Claims Aren't Part of the 14.6% Error Rate
NPP claims are part of the problem. Evaluation and management coding and “incid... Read more
Reimbursement:
This One Tip Can Boost Your Practice's Income by Thousands
Make 2016 your highest income year ever. As you close the books on your 2015 billings,... Read more
Reader Question:
Determine PFSH for E/M Choice
Question: I have a surgeon’s note for an office visit that clearly indicates ... Read more
Reader Question:
Shave Off the Warts With 17110
Question: A patient was taken to the operating room for wart removal, due to the si... Read more
You Be the Coder:
Complicated Abscess Drainage
Question: Our physician reviewed a 56-year-old male patient with complaints of pain... Read more
Allergy Tests:
Scratch or Patch, Avoid a Rash of Allergy Coding Problems
Tip: Code for each allergen, not each scratch. Could one of these skin allergy test... Read more
Compliance:
OIG Recovered $3.35 Billion in 2015, Plans Scrutiny of Services
Place of service errors also continue to be on the agency’s radar screen. Any am... Read more
HIPAA:
Get Ahead of Notification Curve for PHI Breach
Avoid stiff penalties that could hurt your practice. With fines ranging from $100 to $... Read more
Billing:
This MAC Offers 10 Methods to Avoid Appeals
Hint: Modifiers are your friends. If you spend a lot of your valuable time processing ... Read more
Reader Question:
"No Charge" Visits Still Count Toward Established Patient Status
Question: Our dermatologist saw a patient during a quick assessment last year at no char... Read more
Reader Question:
Test EHR Functionality Frequently Post-Implementation
Question: What should our practice do to prevent unintended consequences from electronic... Read more
Reader Question:
Don't Take Chart Amendments Lightly
Question: One of our physicians made mistakes on several charts and printed out new docu... Read more
You Be the Coder:
11721 with E/M
Question: Can I bill Medicare for an E/M visit (99213) along with a debridement of nails... Read more
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