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Dermatology Coding Alert

Sort Out Your AK Chemical Peel Denials by Focusing on Diagnoses and Documentation
Your best defense? An ABN -- but don't forget to apply modifier GA, GY, and GZ. Usin... Read more
Read Your Botox Treatment Report With an Eagle's Eye
Don't miss 5 documentation essentials -- including sites and number of units. When a... Read more
Master Your Modifier 59 Usage With 4 Guidelines
Make sure you're adhering to the correct criteria or suffer being 'red flagged.' A modifi... Read more
Test Your Modifier 59 Know-How With This Derm Example
Try your hand at using modifier 59 (Distinct procedural service). A dermatologist removes ... Read more
READER QUESTIONS:
Biopsy, Frozen Section Go Hand-in-Hand in Pre-Mohs
Question: The surgeon in our practice usually performs a biopsy of the lesion prior to do... Read more
READER QUESTIONS:
Stick to 17110 Even With Histofreezer
Question: If the doctor performs 17110 and uses histofreezer for the procedure, can I bil... Read more
READER QUESTIONS:
Apply 2 Units Only With Drugs or Timed Codes
Question: Can I bill 17250 with two units? Massachusetts Subscriber Answer: You may not u... Read more
READER QUESTIONS:
Use Unlisted Procedure Code as Needed
Question: Should I use 15780 or 15783 for reporting micro dermabrasion? Louisiana Subscri... Read more
READER QUESTIONS:
Dysplastic Nevus Knows No Specifics
Question: What is the proper ICD-9 code for dysplastic nevus? Illinois Subscriber Answer:... Read more
READER QUESTIONS:
Soak Up These Biopsy Coding Tips
Question: I submitted a claim for 11100 and 11101-59 and got denied. Why? New Jersey Subs... Read more
READER QUESTIONS:
Report Warts as Benign Lesions
Question: What is the procedural code for destruction of warts? Do I have to document it ... Read more
READER QUESTIONS:
Use Modifier 25 on Your New Patient E/M, as Necessary
Question: A new patient visits over concerns of multiple lesions. After examining and eva... Read more
You Be the Coder:
High-Risk History Counts for Malignant Melanoma
Question: In our practice, we frequently see patients who don't personally have malignant... Read more
CPT 2010 Update:
Make Sure Your Excision and Radical Resection Codes Measure Up Jan. 1
For radical resections, your dermatologist's documentation must specify this vital detail... Read more
Bid Goodbye to Medicare Consultation Codes in 2010
Good news:You may see a 3 percent increase to your dermatology practice's bottom line. Yo... Read more
3 Steps Draw the Line Between Uncertain, Unspecified Neoplasms
Waiting for the path report can provide you with a more specific diagnosis. Do you know t... Read more
READER QUESTIONS:
Don't Restrict Billing Flap and Graft Codes Together
Question: My dermatologist excised a squamous cell carcinoma from the helical rim of the ... Read more
READER QUESTIONS:
Read Properly Between Biopsy Codes
Question: A patient presented for evaluation of a scaly, red papule on the left nasal sid... Read more
READER QUESTIONS:
Brush Up on Your Breast Lesion Excision Procedure
Question: If we excised a benign mole from the breast of a female patient, do we use code... Read more
READER QUESTIONS:
Recoil Excision Denial by Scrapping 12051
Question: I'd like to know why Medicare denied 12051 after I billed it together with 1144... Read more
READER QUESTIONS:
Cut the Complication of Modifier 51
Question: A surgeon excised 10 inclusion cysts of scalp, all between 1.1 to 2.0 cm. The p... Read more
You Be the Coder:
Test Yourself With This 238.2 Scenario
Question: A patient presents with a suspicious lesion on the lower eyelid. In the chart, ... Read more
Avoid Misrepresenting Phototherapy Services by Following This Expert Advice
To report a separate E/M service, here's what modifier, dx, and documentation you must ha... Read more
Factor Mod 24 Into E/M Service Following Major Surgery
Here's why you should always append your postoperative modifiers first. When your dermatol... Read more
Don't Let Dermabrasion Dollars Slip Through Your Fingers
If you have medical necessity, then get preauthorization with these tips. Although most p... Read more
Differentiate Dermabrasion/Micro Dermabrasion
What is the difference between dermabrasion and microdermabrasion? While the former is a m... Read more
READER QUESTIONS:
Close Lesion Matter by Appending Modifier 51
Question: My physician removed a malignant lesion and closed a layered lesion at the same... Read more
READER QUESTIONS:
Keloid Scar Removal Most Likely Means 17110
Question: Is removal of a keloid scar considered an unlisted procedure? What is the right... Read more
READER QUESTIONS:
Take Into Account Mole Removal's Location, Size
Question: I can' t seem to fit "removal of mole" with any of the existing CPT codes. Plea... Read more
READER QUESTIONS:
Find Your Candida Antigen Code Here
Question: My dermatologist uses candida antigen for wart destruction. Previously, I used ... Read more
READER QUESTIONS:
Remove All Doubts When Coding Dysplastic Nevi
Question: A patient comes in for a shave biopsy which shows a dysplastic nevus that needs... Read more
You Be the Coder:
Avoid Adding Lesion Sizes Together
Question: A doctor removed three lesions from the scalp area with surgitron (a device use... Read more
ICD-9 2010:
Nail Down Neoplasm Coding by Implementing 5 New Codes
A 5th digit on this insurance 'front-gate' diagnosis will prevent kick-outs. Although you... Read more
Bust 4 Myths to Boost Your Blepharoplasty Claims
What you don't know can hurt you -- to the tune of $290. If you assume eyelid proced... Read more
Quick Key:
14 Ways to Show Medical Necessity for Blepharoplasty
Diagnosis of a medical problem helps prove that eyelid procedure wasn't cosmetic. Each ca... Read more
Dodge Dermatitis Test Mishaps to Avoid a Rash of Underpayments
In most cases, you can count every allergen as a separate unit of service. Dermatologists... Read more
READER QUESTIONS:
Check Modifier for Malignant Neoplasm Procedures
Question: I submitted a claim for 14040 and 17311 with diagnosis 173.3. Should I have app... Read more
READER QUESTIONS:
Use Code Pair for Pinpoint Pressure Ulcer Dx
Question: A 75-year-old established patient reports to the internist for inspection of so... Read more
READER QUESTIONS:
Separate Repeat Procedures with Modifier 59
Question: Our dermatologist performs three biopsies in the same area of a patient's outer... Read more
READER QUESTIONS:
Use These Codes for Skin Cancer Screening
Question: My physician sees a patient for a skin cancer screening. Should I use the preve... Read more
READER QUESTIONS:
Make the 17110 and 40810 Distinction
Question: The physician used a laser to remove five lesions of verruca vulgaris on a pati... Read more
READER QUESTIONS:
Strike Out 87101 For Outside Labs
Question: My physician isolated some fungus and sent it to an outside lab. Can we still b... Read more
You Be the Coder:
Encourage Your Surgeon to Document Lesion Size
Question: When a physician states that the lesion/cyst/mass excised from the skin or subc... Read more
Correctly distinguish closure levels every time with this advice
Follow our tips to dig deeper and find the differences. All closures aren't created equal;... Read more
Count HPI, or risk choosing wrong E/M level
How many of the essential 8 questions did your physician document? If you're like many der... Read more
Counting it:
Get your HPI coding answers here
Check yourself against the scenarios on page 12. Example 1: Problem-oriented visit In a ne... Read more
Is Your Everyday Coding In Sync With Payer Rules? Take Our Quiz to Find Out
2 quick scenarios let you brush up on re-excision and measurement skills. Lesion excision... Read more
Correction
One of the reader questions in Dermatology Coding Alert, Vol. 5, No. 1, listed an incorrec... Read more
Reader questions:
Clarify POS codes for mobile services
Question: Our dermatologist and nurse practitioner will be using a mobile van to conduct ... Read more
Reader questions:
V code applies for yearly 'wellness check'
Question: A patient says her insurance provider did not pay our bill for her yearly skin ... Read more
Reader questions:
Multiple punch biopsies are legit
Question: Can we code multiple punch biopsies on a single claim? Our dermatologist sent 1... Read more
Reader questions:
Don't Turn to 'Unlisted' for Keloid Removal
Question: Does CPT include a code for removing a keloid scar? If not, should I report the... Read more
Reader questions:
Consider timing, location, intent for skin biopsy
Question: How do I know when to report skin biopsy separately with, or in place of, other... Read more
You be the coder:
Lesion destruction versus biopsy
Question: How should we bill for a biopsy when we submit it to a pathologist? Our dermatol... Read more
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