Dermatology Coding Alert

Question: Our dermatologist and nurse practitioner will be using a mobile van to conduct skin cancer screenings in multiple locations (nursing homes, supermarkets, parks, etc.). Can we bill for a screening/office visit along with a biopsy or treatment when needed? What place of service codes should I use?

Missouri Subscriber

Answer: You will need to include the correct place of service codes with the claims, depending on where your physician sees the patients. For example, report POS 13 for an assisted living facility, POS 31 for a nursing home, or POS 04 for a homeless shelter. If your physician conducts the screenings in the mobile van itself, look to POS 15 (Mobile unit).

As long as your physician's documentation supports an E/M service with a biopsy and/or treatment, you can bill both services when appropriate. Remember 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 the E/M code to indicate it's separate from the E/M service.