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Dermatology Coding Alert

Lesion removals:
Don't Marginalize Your Lesion Removal Reimbursement
Calculating the lesion size incorrectly can cost more than $30 each time. Lesion excisi... Read more
ICD-10:
Look for Close Malignant Skin Neoplasm Crosswalk
Melanoma and more report to different codes. Not a lot will change once you start repor... Read more
Your ICD-10 Transition Plan Should Encompass 6 Phases,
A working budget should include every aspect of planning, including productivity trainin... Read more
Payer Pointers:
Learn the Ropes of 5 Common Audits Your Practice May Face
Understanding several types of audits can help your practice prepare. If you are gettin... Read more
Compliance:
Watch For Extra Scrutiny of Your Incident-To Billing, E/M Coding, and More
Pay attention to where the OIG will focus to ensure your practice isn't throwing up red ... Read more
Reader Question:
Start With 948 for Burn Dx
Question: Our dermatologist treats burn victims, and I'm wondering about diagnosis codin... Read more
Reader Question:
medical, assistant, E/M, codes
Question: One of our physicians allows his medical assistant to choose his E/M codes. Th... Read more
You Be the Coder:
Skin Rash With Unknown Cause
Question: We recently treated a patient for a skin rash that seemed to be an allergic re... Read more
CCI Update:
12001-13153: Bundle Closure With Most Integumentary Procedures
Report repair alone or with lesion excision only.In case you've ever wondered if you could... Read more
CPT® 2013:
Watch for These E/M Definition Alterations Next Year
Experts ask: Will these descriptor tweaks change your billing?Most dermatology practices b... Read more
Billing Corner:
No-Shows? No Problems With These 4 Expert Tips
No-show fees are one approach, but beware the PR backlash.These days every dollar and ever... Read more
News You Can Use:
Get Used to Revalidation Process, Medicare Warns
Plus: CMS will begin accepting faxed, emailed supporting documents.If CMS's revalidation p... Read more
Reader Question:
15825 or 15828 Best Bet for Rhytidectomy
Question: The dermatologist in our practice removed excess skin from a patient's neck. Is ... Read more
Reader Question:
ICD-9 Freeze Will Spare You New Updates This Year
Question:  Are there any ICD-9-CM updates planned for 2013? Iowa SubscriberAnswer: No... Read more
Reader Question:
Pull Out ABN for Benign Lesion Excisions
Question: Our state Medicaid doesn't cover benign lesion excisions, but we don't know it's... Read more
You Be the Coder:
Histofreezer
Question: If the doctor performs 17110 and uses histofreezer for the procedure, can I bill... Read more
Chemical Peels:
15788-15793 Survival: Diagnosis, Documentation Key to Successful AK Treatment Coding
Applying the right CPT® code in the right circumstance is critical.Expert dermatolog... Read more
Unna Boots:
29580 Tips: Bundle Same-Day Debridements and Applications
Knowing covered diagnoses is key, but don't be afraid to get a waiver.If your dermatologis... Read more
News You Can Use:
Double-Digit Cuts May Strike Your Income Starting in January
Some specialties will be hit hard, unless Congress steps inEvery year around this time, th... Read more
E/M Corner:
3 Steps Lead to MDM Determination Success
Follow our experts' system to calculate each individual piece of the medical decision maki... Read more
Reader Question:
11042 Gets Deep Into Debridement Service
Question: A patient with uncontrolled type II diabetes presents with an ulcer on his lower... Read more
Reader Question:
1 Office Visit Translates Into 1 E/M Code
Question: A patient presented at our office with a bruise. The dermatologist examined the ... Read more
You Be the Coder:
Multiple Arm Lesions
Question: Our dermatologist removed three actinic keratoses from a patient's left arm. Sho... Read more
Biopsies:
Beyond 11100: Discover Coding Success With More Accurate Biopsy Codes
Watch for specific mention of biopsy site in the documentation.Code 11100 is one of the mo... Read more
E/M Coding:
Counting Bullets/Points Differently Can Help You Pick Between '95 or '97 guidelines
Physical exam element can point you to the better set.Choosing whether to follow the 1995 ... Read more
Global Periods:
'XXX'? 'YYY'? Make Sense of the Global Alphabet Soup
Hint: Major and minor procedures differ in days of postop care.Ignoring global periods can... Read more
ICD-10 Outlook:
AMA and Provider Feedback Impact ICD-10 Delay
Don't let changes catch your ophthalmology practice by surprise.CMS hasn't made a final an... Read more
Reader Question:
Consider Coding Chemocauterization
Question: A patient came in for wart removal on his right second toe. The physician perfor... Read more
Reader Question:
Bone Up on Scar Revision
Question: For a patient requiring revision of a scar on his left leg, our surgeon excised ... Read more
Reader Question:
Catch Up on Incomplete Claims
Question: Our practice has a few claims that have missing or incorrect information. I'm no... Read more
You Be the Coder:
2 Infected Decubiti
Question: Our physician debrided two sites with infected decubiti. Should I report ea... Read more
Scar Revision:
11442 Survival Guide: Prove Medical Necessity to Avoid Scar Revision Denials
Tip: Documentation must show that the procedure is not strictly cosmetic. If you're havin... Read more
Denial Management:
Are You Using the Right Specialty Code for Your Dermatologists?
Check with your MAC to make sure you're reporting your practitioners properly. If you rep... Read more
Billing:
Prove Financial Hardship Before Considering Waiving Copays
The key: demonstrated financial need. In seminar after seminar, dermatologists and coders... Read more
Compliance:
Are Your E/M Trends Outside the Norm?
An increase in 99214 and 99215 frequency is attracting attention from OIG. If you examine... Read more
Reader Question:
Carcinoma Excision With Tissue Transfer Closure
Question: My surgeon excised a carcinoma of the face. He closed the excision using adjace... Read more
Reader Question:
V67.00 Accurately Describes Follow-Up After Surgery
Question: If a patient receives treatment and the condition was resolved, which ICD-9 cod... Read more
Reader Question:
Best Bet: Choose 1 Graft Code
Question: We have a surgeon who is placing split-thickness skin grafts on burn patients a... Read more
You Be the Coder:
Biofreeze
Question: A patient came to the office with a bump on her foot; the dermatologist diagnos... Read more
Wound Repair:
12001 or 14000? Choose Wisely Between Tissue Transfers and Wound Repairs
3 steps help your dermatologist get the reimbursement he deserves. When a dermatologist cl... Read more
ICD-10:
172 Update: Look for C43, D03 Melanoma Families in ICD-10
Also: Big changes coming to in situ coding.Even though ICD-10 implementation has been dela... Read more
Billing Basics:
Avoid 10 Common Billing Errors With 10 Expert Tips
Hint: Benefits verification can solve a lot of your denial problems.What's the top tool in... Read more
Reader Question:
Take Into Account Mole Removal's Location, Size
Question: I can' t seem to fit "removal of mole" with any of the existing ... Read more
Reader Question:
Count Prescriptions as Part of E/M
Question: My dermatologist heard that there's a code we can bill and be paid on just for t... Read more
Reader Question:
Ensure That Diagnosis Matches Patient's Condition
Question: When I bill Medicare for deep debridement (11042) using the diagnosis the physic... Read more
Reader Question:
Insurers May Require Bundling Same-Day E/M Services
Question: Can we bill two office visits on the same day? We reported 99214 twice for the s... Read more
You Be the Coder:
Tissue Transfer, Lesion Excision
Question: My dermatologist performed a lesion excision along with a tissue transfer. ... Read more
CPT® 2012:
15100-15278 Survival: 5 Tips for Large Tumor Excision Exemplify Skin Replacement Rules
Know when to capture pay for preparation, placement, and more. With new codes and an updat... Read more
Compliance:
OIG to Send CMS Names of 1,700 Docs Who Overbilled High-Level E/M Codes
Frequency of reporting 99214 and 99215 increased 17 percent over 9-year period.If you exam... Read more
ICD-10 Delay:
Anticipate 1 Extra Year for Your ICD-10 Implementation Schedule
But don't count on the delay quite yet, expert warns.As part of a proposed rule to adopt a... Read more
Billing:
Overcome Primary vs. Secondary Payer Woes with Answers to Your FAQs
Start with the basics and then move on to learning the intricacies.When a patient is cover... Read more
Follow These CMS Rules for Submitting Medicare Secondary Payer Claims
Hint: Copy all beneficiary insurance cards, not just the Medicare one.When Part B practice... Read more
Reader Question:
Use 17110 for Wart Removal Without Cryo
Question: The dermatologist documented, "Dermatology treatment rendered in the form of deb... Read more
Reader Question:
How Should You Bill Medicare?
Question: We are participating with Medicare. We bill and submit claims to Trailblazer (J4... Read more
Reader Question:
Remember to Represent Pressure Ulcer's Stage
Question: An established elderly patient reports to the dermatologist for inspection of so... Read more
Reader Question:
Prolonged E/M Is No Longer Restrictive to Physician Services
Question: How can we report prolonged face-to-face E/M services provided by our dermatolog... Read more
You Be the Coder:
Repeat Excision
Question: My dermatologist removed a malignant mole last week, which I reported with 11600... Read more
Skin Procedures:
11100, 17000, or 17110? Use Method to Select Biopsy or Destruction Code
Follow 3 steps to find the right code for these 3 integumentary procedures. A patient pres... Read more
Billing Errors:
One Medicaid Payer Reveals Its Top 5 Errors -- Know How You Can Avoid Making the Same Mistakes
Coding errors once again top the list of the most common mistakes.Did you catch a miscoded... Read more
Sunburn:
16000 Pay Depends on Documentation of 'Treatment'
Watch out: Not all burn care is created equal -- you may need to code some as E/M.Whi... Read more
Fee Schedule:
You Won't Face 27 Percent Medicare Cut for 2012
Congressional 10-month delay pushes payment formula problems to 2013.For practices fearing... Read more
Reader Question:
15780-15783 Cover CO2 Dermabrasion
Question: How should I code for CO2 laser dermabrasion to treat a basal cell carcinoma?Pen... Read more
Reader Question:
Employ Modifier 79 for Botox Injection During Global
Question: How should we code if a patient recently had surgery and a Botox injection is sc... Read more
Reader Question:
Too Small for Intermediate Closure
Question: I'm aware of a "rule" regarding lesion excision and closure charges that I am qu... Read more
Reader Question:
No Documented HPI Leads to No Coding for New Patient
Question: A new patient visits the dermatologist with a chief complaint. I don't have a re... Read more
You Be the Coder:
Total Body Skin Check
Question: A patient with a history of skin cancer presents for a total body skin check. Th... Read more
Excisions:
11640-11646 Demystified: Can You Conquer These Excision Coding Scenarios?
Referrals, unexpected findings, and multiple excisions -- check out these case studie... Read more
ICD-10:
ICD-10 Date Will Be Postponed, HHS Confirms
Delay could offer practices additional time to prepare for new diagnosis coding system.Jus... Read more
HIPAA:
With Audits Heating Up, Is Your Practice Ready?
Make sure your privacy and security practices are up-to-date.If your HIPAA protocols fall ... Read more
Incident-to Billing:
Shore Up You Incident-To Claims or Face OIG Scrutiny This Year
Ensure your visit meets 4 criteria before filing an incident-to claim.If you don't know ho... Read more
Reader Question:
707.21 Sets the Stage for Complete Pressure Ulcer Dx
Question: An established elderly patient reports to the dermatologist for inspection of so... Read more
Reader Question:
Insurers May Require You to Bundle Same-Day E/M Services Together
Question:  Can we bill two office visits on the same day? We reported 99214 twice for... Read more
Reader Question:
Remember Debridement Includes Dressings
Question: Can our practice be reimbursed for the surgical dressing (supplies) of a partial... Read more
You Be the Coder:
I&D of Multiple Cysts
Question: A patient presents to the office with cysts all over her body. The dermatologist... Read more
Debridement:
11040 and Wound Closure: Look for These Conditions to Justify Separate Reporting
Tip: Pay attention to the level of wound repair to maximize your reimbursement. Many clini... Read more
Part B Update:
Despite CPT® Revision, Medicare Won't Update 'New Patient' E/M Rules for 2012
Plus: Claims reprocessing has completed, so make sure your claims have been corrected.As m... Read more
Documentation:
Make Audit-Proof Record Corrections With These 5 Tips
Documentation clarifications can be a big help -- if you use them wisely.With the ple... Read more
E/M Coding:
'Follow-Up' Is Not A Sufficient Chief Complaint
Improve Your E/M Payment Odds With These 5 Quick TipsMost practices report E/M codes every... Read more
Reader Question:
96900-96999 Cover PUVA, Narrow Band Treatment
Question: What CPT® codes apply for PUVA treatment and narrow band treatment?Maine S... Read more
Reader Question:
709.9 Dx Selection Must Be Backed by Note
Question: When I bill Medicare for deep debridement (11042) using the diagnosis the dermat... Read more
Reader Question:
99241-99255: Keep Consults When Possible
Question: Can we still use "consult" E/M codes?North Carolina SubscriberAnswer: The answer... Read more
Reader Question:
Pay Attention to Month, Not Year, With Birthday Rule
Question: I just received a call from a patient's parent claiming that we didn't follow th... Read more
Reader Question:
Prepare Wisely for Payer Fee Negotiations
Question: We're getting ready to begin contract renewal negotiations with one of our payer... Read more
You Be the Coder:
Testing Multiple Allergens
Question: My dermatologist scratch- tested a patient, who complains of skin rashes, f... Read more
CCI 18.0 Update:
Include Compression Therapy in Many Skin Graft Codes
Look for different sessions or sites before you try to break these bundles. If your dermat... Read more
Medicare Errors:
Providers Underbilled More Than $1 Billion to Medicare in 2010
CERT results reveal $34.3 billion in improper Medicare payments -- $1.1 billion of wh... Read more
Part B Payment:
Congress Votes to Boost Conversion Factor Through February 29
At nearly the last minute, lawmakers ensure that you won't lose 27 percent.Although the go... Read more
CPT® 2012:
Don't Miss These Clarifications About New Patients and 'Qualified Healthcare Professional'
See how changes affect your use of 99201-99205, 99460-99461, and more. Coding guidelines c... Read more
Reader Question:
692.x May Be Good Choice for Unknown Skin Rashes
Question: We recently treated a patient for a skin rash that seemed to be an allergic reac... Read more
Reader Question:
ICD-10 Prep Is Different for Paper Claims
Question: If we file paper claims to Medicare, will the claims form change once we be... Read more
Reader Question:
Only Add Lacerations at Same Site and Level
Question:  A patient with a 1.5-cm laceration on his eyebrow presented to our practic... Read more
Reader Question:
No HPI Equals No Coding for New Patient
Question: A new patient visits the physician with a chief complaint. I don't have a review... Read more
You Be the Coder:
Chemical Peel
Question: Our dermatologist used glycolic acid to remove actinic keratoses from around a p... Read more
Biopsies:
11000 Is Just the Start: Explore Site-Specific Bx Codes and Net $78 or More
Boost claims accuracy by avoiding these common biopsy coding pitfalls. If you automaticall... Read more
Rural Care:
Protect Your Bottom Line: Implement These Revalidation Letter Requirements
Here's the lowdown on how these CMS changes apply to your practice.If you're a rural healt... Read more
ICD-10:
Prepare for ICD-10 Conversion With 2 Simple Tips
Know your anatomy and physiology if you want a quick transition.It's not too early to star... Read more
CPT® 2012:
Establish Whether a Patient Is New With CPT®'s Latest E/M Tweaks
New rules place emphasis on subspecialties. It's an age-old debate -- when an establi... Read more
5010 Readiness:
Medicare Won't Penalize You for 5010 Non-Compliance Until March 31, 2012
Plus: Avoid PO boxes on 5010, despite what your MAC tells you.Sweating over the fact that ... Read more
Reader Question:
V16.8 Tells Family Melanoma Risk Story
Question: In our practice, we frequently see patients who don't personally have malignant ... Read more
Reader Question:
Diagnosis Is Related to E/M Level, But Doesn't Dictate Code
Question: Our dermatologist saw an established patient with severe chronic skin allergies.... Read more
Reader Question:
Modifier 55 Won't Apply to Suture Removal
Question: An 11-year-old established patient went to the emergency room in another state o... Read more
Reader Question:
Know GC Rules for Resident Surgical Assists
Question: When a resident assists a surgeon in a teaching hospital, do we need to add modi... Read more
You Be the Coder:
Mohs With Frozen Section
Question: The surgeon in our practice usually performs a biopsy of the lesion prior t... Read more
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