Wiki Full body skin exam

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andersont

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It is my understanding that there are no preventive codes for deem. Is this correct?

I had an insurance call me because the patient questioned why they didn't pay (went towards deduct) for his preventive skin screening (we billed 99213). He also had some AK's and SK removed along with a box.

Thank you
 
Preventive Codes

No there are no preventative care codes for Dermatology. Hopefully in the future the insurance co's will understand how important it is to have a full skin exam.

Colleen P. Gifford, CPC, CPCD
 
Most carriers (and Medicare) don't cover skin cancer screening by specialists as a preventive service. It's usually performed by a general practitioner such as a family practice provider, or internist as part of a general physical or annual wellness visit.

Most patient's don't understand this or think their service is free.

Consider this like a free brake check at Midas. Sure, they will do a free 12-point inspection on your brakes, but it doesn't include fixing anything or making the decisions on how to repair any problems they found. Once you start geting into diagnosing, treating, and fixing, it costs money.
c
Whenever a problem is found as part of this "screening", the visit gets converted to a regular E/M like you billed. But the screening portion isn't usually a payable service for dermatologists. There are a few exceptions, but most don't cover it.

Aetna, UHC, and Medicare have policies specifically stating they don't cover skin cancer screenings.
 
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