Dermatology Coding Alert

Question: A new patient with a red, itchy rash on her arm comes to our practice. Our dermatologist makes an initial diagnosis of nonspecified contact dermatitis (692.9, Contact dermatitis, NOS). After thorough examination, the dermatologist applies the patch tests the same day and asks the patient to return in 48, 72, and 96 hours for readings. How should we code this?


Michigan Subscriber

Answer: You should report 95044 (Patch or application test[s] [specify number of tests]) because the dermatologist applied the patch tests.

You should also bill for the E/M services the dermatologist provides to the patient. You should determine the most appropriate E/M code (99201-99205) to report based on the scope of the examination and the key components the dermatologist covers with the patient.

Don't forget: You have to append modifier -25 (Significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure or other service) to your E/M code  to notify the payer that the dermatologist performed an initial evaluation that led him to complete patch testing  on this patient.