Why Dermatology billing is different.
Dermatology billing expertise.
- Biopsy coding by technique: tangential, punch and incisional
- Benign and malignant excision coding by size and site
- Mohs micrographic surgery stage and block coding
- Destruction of premalignant and benign lesions
- Repair coding for intermediate and complex closures
- Phototherapy billing
- Cosmetic service separation and patient financial policies
- Pathology-driven coding updates before submission
Common Dermatology codes we work with.
| Code | Description |
|---|---|
11102 | Tangential biopsy of skin (e.g., shave, scoop, saucerize, curette); single lesion |
17000 | Destruction of premalignant lesions (e.g., actinic keratoses); first lesion |
17003 | Destruction of premalignant lesions; second through 14 lesions, each |
11642 | Excision, malignant lesion including margins, face, ears, eyelids, nose or lips; excised diameter 1.1 to 2.0 cm |
17311 | Mohs micrographic technique, head, neck, hands, feet, genitalia; first stage, up to 5 tissue blocks |
96910 | Photochemotherapy; tar and ultraviolet B (Goeckerman treatment) or petrolatum and ultraviolet B |
CPT® is a registered trademark of the American Medical Association. Codes shown are examples; correct coding depends on documentation and payer policy.
Our processDermatology billing process.
Registration and Eligibility
- Benefit verification for procedures and pathology
- Cosmetic service identification and patient consent
- Prior authorization for biologics and phototherapy
- Patient cost estimates before procedures
Dermatology Coding
- Lesion size and site from procedure notes
- Benign versus malignant coding after pathology results
- Mohs stage and block counts
- Repair and closure coding
Claim Submission
- Scrubbing for multiple-procedure and bundling edits
- Modifier assignment for multiple lesions
- Holding excision claims for pathology where appropriate
- Daily electronic submission
Denial Management
- Medical necessity appeals for lesion removal
- Modifier and bundling corrections
- Biologic and phototherapy coverage appeals
- Prevention through documentation feedback
Analytics
- Procedure revenue by provider
- Mohs and surgical volume trends
- Medical versus cosmetic revenue split
- Payer and denial trends
Dermatology billing FAQs.
Why wait for pathology before billing an excision?
Excision codes differ for benign and malignant lesions, and malignant excisions are reimbursed at higher rates. Coding after the pathology report confirms the diagnosis ensures the correct code and supports medical necessity.
How are excisions sized for coding?
Excision codes are based on the lesion's greatest diameter plus the narrowest margins required, measured before the excision. Clear documentation of these measurements is essential for accurate coding.
How do you bill multiple biopsies in one visit?
The first biopsy is reported with a primary code and each additional biopsy with an add-on code, based on the technique used. When different techniques are used, the hierarchy rules determine which is primary.
How do you handle cosmetic procedures?
Cosmetic services are not covered by insurance, so we help you identify them up front, collect payment from the patient and keep them off insurance claims to avoid compliance issues.