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Dermatology Coding Alert

CPT® 2012 Update:
New Codes Abound for Skin Substitutes
Plus: Check out time guidelines for initial observation codes. Have you ever wished that C... Read more
ICD-9 Coding:
700 Basics: Take the Rough Edge Off Corn and Callus Coding
Will you know what to do when these little-known terms show up in your doctor's documentat... Read more
E/M:
HPI Know-How Helps You Catch Level 4 and 5 E/M Opportunities
Beware of CPT® and Medicare differences when counting HPI elements.Not accurately ac... Read more
Reader Question:
Include Dressings in Debridements
Question: Can our practice be reimbursed for the surgical dressing (supplies) of a partial... Read more
Reader Question:
25 or 57? Don't Mix Modifiers
Question: I'm always at a loss on whether to use modifier 25 or modifier 57 when the derma... Read more
Reader Question:
Know Your State Laws, Payer Rules Before Sending Patient to Collections
Question: I work in a physician's office handling the collection of past due copays, deduc... Read more
Reader Question:
Collect Surgical Deductibles Up Front
Question: We often have patients who don't pay their deductible after surgery. Is there a ... Read more
You Be the Coder:
Full-Thickness Graft
Question: The dermatologist excises a basal cell carcinoma tumor from a patient's nas... Read more
AK Treatments:
17000 or 96567? Base AK Treatment Coding on Method, Number of Lesions
Freezing. lasers, PDT, or shaving -- the correct code can be worth over $170. Million... Read more
ICD-10 Countdown:
Get Ready or Get Fined -- That's the CMS Message
Explore 6 FAQs to ramp up your ICD-10 coding know-how.Denials aren't the only thing you ha... Read more
Diagnosis Coding:
6 Tips Help Keep Your ICD-9 Coding on Track
Cheat sheets come with a warning label.To help ensure your coding complies with ICD-9 guid... Read more
Part B Updates:
Vendor Won't Be Ready for 5010? Get Claims in Before 2011 Ends, CMS Advises
Plus: E-prescribing hardship exemptions are due in November, CMS reminds.Practices from al... Read more
E/M Coding:
Only 'Treating Physician' Can Report Subsequent Observation Care, CMS Clarifies
All other doctors who evaluate the patient must report outpatient E/M codes.In effect for ... Read more
Reader Questions:
Find Your Candida Antigen Code Here
Question: My dermatologist uses candida antigen for wart destruction. Previously, I used c... Read more
Reader Question:
99360 Is One to Skip for Medicare Billing
Question: Our dermatologists sometimes "standby" for other surgeons in some high-risk proc... Read more
Reader Question:
Disregard Generic Code for Plantar Wart
Question: A patient reports to the dermatologist with a painful right foot. The dermatolog... Read more
You Be the Coder:
Lacerations At Same Site
Question: A patient with a 1.5-cm laceration on his eyebrow presented to our dermatology p... Read more
Neoplasms:
238.2 or 239.2? 3 Steps Draw the Line Between Uncertain, Unspecified Neoplasms
238.2 or 239.2? 3 Steps Draw the Line Between Uncertain, Unspecified Neoplasms Waiting for... Read more
Dermabrasion:
15780-15781 Payments May Be At Risk Without These Tips
Hint: If you have medical necessity, then get preauthorization.Although most payers consid... Read more
ICD-10 Readiness:
Start Small When Prepping for ICD-10 Conversion, CMS Says
Acquaint yourself with the top 30 diagnoses that your practice sees and you'll get a head ... Read more
Version 5010:
Make Sure Your Electronic Transactions Don't Bomb on Jan. 1
Compliance, payment, and ICD-10 hang in the balance.Say goodbye to forms 4010/4010A1 for e... Read more
Reader Question:
99214: Give Credit For Time Spent With Patient
Question: Our physician spends a lot of time discussing treatment options, imaging results... Read more
Reader Question:
14040 Includes Lesion Removal and Tissue Transfer
Question:  If the dermatologist performs an adjacent tissue transfer, can I also code... Read more
Reader Question:
Can Provider Change Tax ID?
Question:  One of our physicians wants to stop billing under the group's tax ID and s... Read more
Reader Question:
Condition Doesn't Change Patient Status
Question:  Our office saw a patient six months ago for a certain condition, and sent ... Read more
You Be the Coder:
Multiple Lesion Fragment Excisions
Question:  I just received a pathology report back that reads: "The largest segment m... Read more
Burn Treatments:
16000-16030 May Not Tell Entire Burn Treatment Story
There's more to the procedures than dressing, debridement -- sometimes almost $900 mo... Read more
HCPCS Level II 2011:
G0440, G0441: Level the Skin Substitute Playing Field With These Codes
Halt 15340, 15360 'global days' prejudice.When your dermatologist applies a tissue-culture... Read more
ABN:
You Must Use New Form by Nov. 1, CMS Says
Don't expect major changes, but you are required to switch.You should be used to the combi... Read more
Diagnosis Coding:
Follow 5 Steps for Audit-Proof Medical Necessity
Keep current and accurate training and records.With a solid ICD-9 coding policy, your derm... Read more
Reader Question:
17110 Is Better Choice for Common Wart Removal
Question: The physician used a laser to remove five lesions of verruca vulgaris on a patie... Read more
Reader Question:
Multiple 69100s Cover Multiple Punch Biopsies
Question: Can we code multiple punch biopsies on a single claim? Our dermatologist sent 11... Read more
Reader Question:
Steer Clear of 'Seen and Agreed' Note or Face Denials
Question: Our physician works with residents each year. It's very time consuming, but he d... Read more
Reader Question:
Know When to Bill Secondary Payer
Question: We have many patients with secondary insurance, some of which have deductibles o... Read more
Reader Question:
Get Payer Advice in Writing Regarding Employee Copays
Question: My physicians are looking at giving employees a courtesy for their co-pays but w... Read more
Reader Question:
12001-12007 Closes the Deal for Dermabond Closure
Question: An established patient visited our office because of severe hyperkeratosis affec... Read more
Reader Question:
90058 May Help You Collect Extra for Emergency Walk-Ins
Question: We recently hired a new dermatologist who is questioning whether we can bill any... Read more
You Be the Coder:
Layered Closure After Melanoma Excision
Question: Following a melanoma excision, our surgeon performed a layered closure. I've hea... Read more
Lesion Repair:
13100: Layers Plus Complexity Brings Home More Pay
Dig deeper to find the key to 'simple,' 'intermediate,' and 'complex' closures.Getting the... Read more
Diagnosis Coding:
Follow These 4 Steps to Master 940-949 Burn Diagnoses
Proper ICD-9 coding for burn patients can require several codes.Dermatology coders who can... Read more
Version 5010:
Get Your Practice Ready For the Upcoming Version 5010 Challenges
The 2012 implementation deadline won't change, so now's the time to start preparing.Over t... Read more
What Is 5010 Really?
The Accredited Standards Committee (ASC) X12 develops electronic data interchange (EDI) st... Read more
Reader Question:
Recoil Excision Denial by Scrapping 12051
Question: I'd like to know why Medicare denied 12051 after I billed it together with 11440... Read more
Reader Question:
Distinguish Consultation, Transfer of Care
Question: We commonly see patients referred by another physician. Our dermatologist perfor... Read more
Reader Question:
'Complete' ROS Considers All Systems
Question: For a level 4 or 5 new patient E/M, I've heard mixed report s about what constit... Read more
You Be the Coder:
Toenail Excisions and Cauterizations
Question: A patient presents for a follow-up of an ingrown toenail. The physician finds th... Read more
ICD-9 2012 Update:
173.0-173.9 Get Specific Next Year With New Fifth Digits
Expanded diagnosis code sets will allow coders to classify whether skin cancer is basal, s... Read more
Undercoding:
Answer the $56 Question -- Are You Downcoding Your E/M Visits?
You're not only losing revenue -- you're also coding improperly.National insurer data... Read more
Get to Know Your New Skin Cancer Dx Codes
In October, you'll see a few changes in the 173 (Other malignant neoplasm of skin) series ... Read more
ABNs:
Tackle Non-Covered, Non-Medicare Services With ABN-Style Waiver
Skipping this step may lead to angry patients and lost reimbursement.You know that you nee... Read more
Reader Question:
11400s Max Out With Margin Measurements
Question: If our surgeon removes a sebaceous cyst from the back that measures 2.5 x 1.75 x... Read more
Reader Question:
Timely Filing Rules May Depend on State Law
Question: One of our commercial payers has a timely filing rule that says we have to file ... Read more
Reader Question:
Review Incident-To Guidelines For Follow-Ups
Question: One of our non-physician practitioners saw a patient during a follow-up visit. W... Read more
Reader Question:
Choose Either 17110 or 17111 for Removal, Not Both
Question: The dermatologist removed plantar warts from each of a patient's feet. Do I subm... Read more
You Be the Coder:
Debridement of Infected Decubiti
Question: Our dermatologist debrided two sites with infected decubiti. Should I report eac... Read more
Mohs Procedures:
17311-17315 Means Dermatologist Must Wear 2 Hats
Is the physician also acting as the pathologist? If not, consider excision codes instead.T... Read more
Modifiers:
Document Increased Derm Services for Modifier 22 Success
If excessive wart removal leads to longer operational time, you may have a case for report... Read more
E/M Coding:
Stop Forfeiting Level Four and Five E/Ms With 3 PMFSH Tips
Make your dermatologist's job easier by letting the patient or nurse document the history.... Read more
Aspects of PFSH
Per CPT®, past medical, family and/or social history is divided into three subsectio... 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 preven... Read more
Reader Questions:
Beware Tacking on Additional Patient Charges
Question: Can you charge a processing fee or a "statement" fee to past due patients when w... Read more
Reader Questions:
Consider Other Sources When CCI Doesn't Provide Info
Question: Sometimes I cannot find my two-code pair in the CCI edits. How do I know which c... Read more
Reader Questions:
Skip No-Show Fees for Referrals
Question: Can a physician who refers a patient to another physician (specialist) charge hi... Read more
You Be the Coder:
Repeat Wart Freezing Within Global
Question: Eight days after an initial wart freezing, the patient returns, and the dermatol... Read more
Phototherapy:
96900 or 96910? The Answer Could Mean $70 for Each Vitiligo Treatment
Avoid misrepresenting phototherapy services by following this expert advice.Is your dermat... Read more
Denials Management:
Bust 4 Common Myths to Overcome MUE Denial Challenges
Hint: You can't report axillary hidradenitis procedures more than twice per day.Medicare d... Read more
ASC Payments:
These 5 Tips Will Make Your Derm ASC Coding A Snap
Check out the new 2011 payment rates for dermatology procedures performed in an ambulatory... Read more
Reader Questions:
Complex Lesions Justify Larger Lesion Codes
Question: Would you clarify the difference between a simple and complex incision and drain... Read more
Reader Questions:
Choose Either 17110 or 17111 for Removal, Not Both
Question: The dermatologist removed plantar warts from each of a patient's feet. Do I subm... Read more
Reader Question:
Describe Follow-Up Visits Accurately With V Codes
Question: If a patient receives treatment and the condition was resolved, which ICD-9 code... Read more
Reader Question:
Friction Burns Still Count As 'Burns'
Question: A patient presented with multiple friction burns from a treadmill. He had partia... Read more
Reader Question:
Solve Unknown Skin Rash Dx Issues With NOS Code
Question: A patient recently reported to our office with a rash on his chest and abdominal... Read more
Reader Question:
Make Sure You Meet Incident-To Criteria
Question: We have a new physician assistant in our office who sees patients for the dermat... Read more
You Be the Coder:
Diaper Rash
Question: Which diagnosis code should I report for a monilial diaper rash?New York Subscri... Read more
Dermatitis Tests:
95004 Underpayments? Make Sure You're Counting Every Allergen
Understand the difference between scratch tests and patch tests to maximize coding accurac... Read more
AK Removals:
17000-17111 With 99201 Can Bring In $120
Follow these 3 tips for your E/M and lesion removal procedures.When your dermatologist per... Read more
PQRI:
Want to Show Your Exemption From the E-Prescribing Penalty? Use New G Codes, CMS Says
Three new codes show your MAC why you collect your full pay next year.Never fear -- i... 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 patie... Read more
Reader Questions:
Update Your Software and Billing With 2011 CPT Modifier Changes
Question: We read lots of information about CPT 2011 code changes, but are there any modif... Read more
Reader Questions:
Choose Burn Treatment Code Based on Degree
Question: A patient with blisters on his shoulders from sunburn came into our office. The ... Read more
Reader Questions:
Extensive Cleaning May Mean a Higher-Level Code
Question: A patient presents with a 1.5-cm laceration of the eyebrow, and the dermatologis... 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
Reader Questions:
Avoid Adding Lesion Sizes Together
Question: A doctor removed three lesions from the scalp area with surgitron (a device used... Read more
You Be the Coder:
Flap and Graft Together
Question: My dermatologist excised a squamous cell carcinoma from the helical rim of the p... Read more
Blepharoplasty:
15822-15823 Payment Depends on Proving Medical Necessity
Are these coding misconceptions costing you over $300?If you assume eyelid procedures are ... Read more
Rural Care:
Check New Preventive Service Fee Waivers for Medicare Patients
PPACA waived fees starting Jan. 1, but CMS won't until April 4.If you code for a rural hea... Read more
Part B Mythbuster:
These 7 Deadly Myths Could Damage Your Practice
Test yourself against these coding and compliance pitfallsDoes your staff subscribe to any... Read more
Modifiers:
Modifier GZ Denials Will Arrive Faster, Thanks to New CMS Transmittal
No more 'complex medical review' for these non-covered services.Most of the time, when Med... 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:
Check Modifier for Malignant Neoplasm Procedures
Question: I submitted a claim for 14040 and 17311 with diagnosis 173.3. Should I have appl... Read more
Reader Questions:
Choose 25 or 57 With These Guidelines
Question: I'm confused about the distinction between modifiers 25 and 57. Could you please... Read more
Reader Questions:
Submit All Claims to a Contracted Payer
Question: We have a patient who wants us to give her the allowable amounts for a procedure... 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 preven... Read more
You Be the Coder:
Unknown Skin Rash Dx
Question: A patient recently reported to our office with a rash on his chest and abdominal... Read more
Closures:
12001 or 13100? Consider More Than Layers to Code Correct Closure Level
Follow our tips to dig deeper and find the differences between 'simple,' 'intermediate,' a... Read more
Evaluation and Management:
Stop Letting ROS Conundrums Thwart Your Level 4 and 5 E/M Coding
Ensure you have documentation of each system -- or prepare to assign a lower code.Lev... Read more
Part B Payment:
CMS Tweaks 2011 Conversion Factor
Despite adjusted rate of 33.9764, changed RVUs should ensure that your payments will stay ... Read more
Reader Questions:
Ask Doctor for Correct Units of Measurement
Question: How should I code for a 0.05-cc injection of Kenalog into an acne cyst? The HCPC... Read more
Reader Questions:
Explore CCI, Fee Schedule for Modifier Details
Question: We sometimes get denials that appear to be related to bundling issues but I can'... Read more
Reader Questions:
Don't Mix Family History With Personal History
Question: My understanding has been that I cannot bill for "family history of" a condition... 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:
Consider Skin Biopsy Timing, Location, Intent
Question: How do I know when to report skin biopsy separately with, or in place of, other ... Read more
Reader Questions:
Stop Omitting 25 Because of Same Diagnosis
Question: I was recently told in a class that you do not need different diagnosis codes to... Read more
You Be the Coder:
Apligraf Applications
Question: If a dermatologist were to apply an Apligraf in his office, how would we code an... Read more
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