Category: Dermatology

Consultation Coding in 2023
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Consultation Coding in 2023

December 15, 2022 Question: In 2023, will the level of service be determined by history, exam and medical decision making, or will this change?  I have heard it is changing. Answer: Beginning January 1, 2023, consultation codes 99242-99255) for both inpatient and outpatient services will be based on medical decision making or time.  However, keep...

Denial for 99214
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Denial for 99214

November 17, 2022 Question: I work with Dermatologists. I have taken a couple of your online webinars. I have a question regarding a denial of office visit 99214, I hope you can answer. The denial indicates that medical records do not support the level of service. In that type of situation, can we rebill the...

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...

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