In-depth articles on dermatology billing services, technique-specific biopsy coding, size-based excision rules, Mohs surgery staging and dual-role requirements, lesion destruction counting, and how to maximize reimbursements for dermatology practices.
Dermatology billing requires precision in coding due to the procedure-heavy nature of the specialty and the strict rules governing biopsy, excision, destruction, and Mohs surgery reporting. Biopsy coding changed significantly with the introduction of technique-specific codes (shave biopsy 11102, punch biopsy 11104, incisional biopsy 11106), each with its own add-on codes for additional lesions. Selecting the wrong technique code or incorrectly sequencing primary and add-on biopsy codes is a leading cause of dermatology claim denials.
Excision coding in dermatology is size-dependent and requires documentation of the excised diameter plus the narrowest margin, reported as a single measurement. The distinction between benign excision codes (11400 series) and malignant excision codes (11600 series) carries significant reimbursement differences, and pathology results must support the code billed. Mohs micrographic surgery billing is among the most complex in all of medicine, requiring the surgeon to serve in a dual role as both surgeon and pathologist, with separate reporting for each stage and tissue block examined. Lesion destruction coding requires accurate lesion counts and proper use of the benign (17110-17111) versus premalignant (17000-17004) versus malignant (17260-17286) code families.
The cosmetic versus medical necessity distinction in dermatology creates additional billing complexity. Procedures performed for cosmetic purposes are not covered by insurance and must be clearly separated from medically necessary services in both documentation and billing. Medtransic provides specialized dermatology billing services that ensure accurate technique-based coding, proper excision measurement documentation, compliant Mohs surgery billing, and clear delineation between cosmetic and covered services. Our team helps dermatology practices maximize reimbursement while avoiding the audit risks that come with this high-scrutiny specialty.
Need help with dermatology billing? Contact Medtransic today. Call 888-777-0860 or visit our contact page.