Category: CC-Dermatology

Billing Multiple Units
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Billing Multiple Units

September 22, 2022 Question: When billing 4 units of 11620 (4 charges with 1unit a piece with 76 modifier) to a Medicare Advantage plans we are getting denied for MUE stating that 3 units can only be reimbursed on the same date. Will changing the modifier to 59 bypass this edit or is it Medicare’s...

Attempted Foreign Body
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Attempted Foreign Body

August 25, 2022 Question: When billing a foreign body removal code of 10120, the surgeon incises the finger and looks around for 25 mins and no foreign body is found, do we bill a 52 since no FB was found or do we bill the 10120 without the modifier since the provider did perform the...

Diagnosis Coding Help
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Diagnosis Coding Help

July 28, 2022 Question: Can you please assist with the diagnosis for a Compound Dysplastic Nevi of back? Biopsy confirmed and not completely excused. Patient comes in for excision of lesion. What diagnosis code should I use? Answer: The correct diagnosis code for a dysplastic nevi of the trunk is D22.5 (melanocytic nevi of trunk)...

Mohs Coding Dilemma
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Mohs Coding Dilemma

June 30, 2022 Question: I am new in Dermatology coding and am currently coding for a Mohs surgeon. I was instructed that if the patient comes in and does not have a confirmed malignancy based on a pathology report and the physician does a biopsy to confirm the malignancy prior to Mohs surgery we can...

CPT code 10080 versus 10081
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CPT code 10080 versus 10081

June 2, 2022 Question: I am trying to code an I&D of a pilonidal cyst. CPT 10080 is simple and 10081 is complicated. How to do I know which code to choose? Answer: Great question, you would report CPT 10081 (complicated) if the procedure requires marsupialization, approximation of the wound’s edges, and/or primary closure. *This...

Counting Problems Addressed for Medical Decision Making
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Counting Problems Addressed for Medical Decision Making

March 24, 2022 Question: If a patient has one stable chronic illness and one acute uncomplicated illness without systemic symptoms, can we “up” the level of Problems Addressed to Moderate? Answer: No, sorry, unfortunately it does not work that way. The problems are no additive or cumulative. One stable chronic illness and one acute uncomplicated...

Waiving Medicare Cost-share for Telehealth Visits
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Waiving Medicare Cost-share for Telehealth Visits

March 10, 2022 Question: I heard that Medicare patients don’t have to pay their deductible or coinsurance if they have a telemedicine visit. Is this true? Answer: Medicare is not waiving deductibles or co-insurance. However, they are allowing providers to do so at their discretion without penalty for telemedicine visits. This means the provider will...

2021 E/M Guidelines MDM Table
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2021 E/M Guidelines MDM Table

February 24, 2022 Question: We are using the 2021 E/M guidelines in the office and in most cases base the level of service on medical decision making.  If I have a patient with a chronic condition that is stable who also has diabetes in which the Internist (nor our specialty) is managing, can I assume...

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