CPT Codes For Dermatology Billing

Administrative dermatology practices stand out for their unique medical billing and coding guidelines, which are tailored to the specialty and reflect its various services. Yet, these specifications can be challenging due to their complexity and the sheer volume of codes. Dermatology requires medical and surgical aspects, so it necessitates a comprehensive understanding of the most common CPT codes for dermatology billing.

In this article, we’ll elaborate on the CPT codes, covering common E/M(Evaluation and Management) codes and codes for dermatological procedures, such as skin biopsies, laser treatments, and cosmetic procedures. We’ll also explore outsourcing solutions to streamline billing processes and ensure compliance with the intricate dermatology coding requirements.

Overview of CPT Codes in Dermatology

Current Procedural Terminology, or CPT codes, serves as standardized language within the administrative medical billing sector, including dermatology. Understanding and properly utilizing CPT codes is imperative for several compelling reasons.

First, this standardized language offers a structured system for identifying and billing dermatological procedures, as well as evaluating and detailing the services rendered by professionals during a patient visit. It ensures clear communication between healthcare providers, insurers, and regulatory bodies.

Second, CPT codes are five characters long and may be numeric or alphanumeric, enabling precise evaluations of dermatological procedures. Each code conveys specific information regarding diagnoses, treatment plans, complexity, etc. Lastly, CPT codes ensure accurate reimbursement based on the intensity of dermatological services.

Common Evaluation and Management (E/M) Codes

Evaluation and Management, or E/M codes, are structured code systems utilized by dermatologists to represent services rendered during a patient’s treatment. They’re frequently used in dermatology for office visits, consultations, and follow-up visits.

When submitting a claim with E/M codes, we advise clarifying if the patient is new or returning, as these codes have specific criteria for either individual. For example:

• New patients are those who have not received dermatological services from a physician or any other practitioner of the same specialty within the last three years.
• Returning patients are those who have received dermatological services from a physician or other practitioner from the same specialty within the last three years.

Time and complexity-based codes

Billing E/M services in dermatology can also be based on the time and complexity of patient visits. The most common CPT codes for time-based billing include:

• 99202 – 15-29 minutes
• 99203 – 30-44 minutes
• 99204 – 45-59 minutes
• 99205 – 60-74 minutes

And for complexity-based visits:

• 99212 – Referring to a straightforward level of complexity and minimal risk or chance of complications.
• 99213 – Representing low levels of complexity and low risk of complications.
• 99214 – Indicating moderate complexity with moderate risks or chances of complications.
• 99215 – Specifying high complexity levels with high risks of complications.

Skin Biopsy and Lesion Removal Codes

Skin biopsy and lesion removal procedures are common practices within the dermatological sector of healthcare. Each service has specific CPT codes that indicate and explain various aspects of the procedures. The most common CPT codes are:

• 11102 – Represents a tangential skin biopsy for a single lesion.
• 11103 – Refers to tangential biopsy for every extra or separate lesion.
• 11104 – Indicates a punch biopsy for one lesion.
• 11105 – Represents a punch biopsy for each additional or separate lesion.
• 11106 – Refers to a single lesion skin biopsy by incision.
• 11107 – Indicates incisional skin biopsy for every additional lesion.
• 40490 – Specifies lip biopsies.
• 69100 – This is for an external ear biopsy.

Lesion removal can involve various procedures like electrosurgery, cryosurgery, laser surgery, or chemical therapy to eliminate benign, premalignant, or malignant growths. Common codes for this include:

• 17000 – Refers to the removal of initial or premalignant lesions, such as actinic keratoses.
• 17003 – Represents destruction of 2-14 premalignant lesions, such as actinic keratoses.
• 17110 – Specifies the elimination of up to 14 benign lesions outside the categories of skin tags and cutaneous vascular proliferative lesions.

Source: freepik.com

Cryotherapy and Destruction of Benign and Malignant Lesions

Cryotherapy, or cryosurgery, is a dermatological procedure that involves using extreme cold to treat various dermatological conditions. Some of the most common CPT codes are:

• 17000-17286 – These CPT cryotherapy codes cover different body areas and lesion types.

In addition, destruction procedures can be described in several CPT codes. They are the following:

• 17110-17286 – For dermatological destruction of skin lesions based on body areas and lesion types.

Phototherapy and Laser Procedures

Phototherapy and laser procedures are common for treating various skin conditions and aesthetic concerns. Each service can be represented with specific CPT codes indicating different types of treatments. It uses the following CPT codes for dermatology:

• 96900 – Represents actinotherapy by utilizing UV light.
• 96910 – Indicates a dermatological procedure using tar and UVB light applications, also known as photochemotherapy.
• 96567 – Refers to exogenous photodynamic therapy for the premalignant treatment and malignant lesions.
• J7308 – Specifies dermatological procedures that utilize intranasal aminolevulinic acid hydrochloride.

Furthermore, the codes most commonly used for laser procedures include:

• 96920/96921 – Referring to laser therapy for treating inflammatory skin conditions.

Cosmetic Dermatology Procedures

Cosmetic dermatology is a common branch focusing on enhancing the appearance of the skin on the face and neck. Procedures such as skin peels and dermabrasion might improve a patient’s well-being and confidence by rejuvenating and refining the skin. For instance, dermabrasion, as a common dermatological procedure, uses these CPT codes:

• 15780 – Specifies a dermabrasion procedure for the entire face.
• 15781 – Referred to a dermabrasion procedure on a segmental area of the face.

Chemical skin peels also fall under the branch of dermatology, using specified CPT codes such as the following:

• 15788 – Indicating an epidermal chemical peel performed on the face.
• 15789 – Referring to a dermal chemical peel procedure.

Telemedicine and Telehealth Services

Telemedicine and telehealth services in dermatology enable patients to consult with professionals remotely via technology, offering safety and convenience. Through video consultations or phone calls, patients can receive diagnoses, treatment plans, and medication prescriptions.

We must say that telemedicine or telehealth can’t always replace in-person visits, but it provides access to ongoing care for various conditions for patients living in remote areas. CPT codes applicable for these services include:

• 99201-99215 – Used for office or other outpatient visits and represent various levels of E/M services provided by professional healthcare providers.
• G0425 – G0427 – Commonly utilized for telehealth consultations, emergency departments, or initial inpatient services. They indicate remote medical services provided via telecommunication.

Outsourcing Options for Dermatology Billing

Many providers face common challenges in dermatology billing due to the overwhelming complexities of coding, documentation, and compliance requirements. Poor coding practices may cause delayed or denied reimbursement, revenue leakage, and regulatory issues.

As a result, outsourcing dermatology billing processes to specialized third-party vendors offers a revolutionary solution, streamlining billing procedures and optimizing revenue capture. At CLICKVISION BPO, we provide comprehensive dermatology medical billing services to help providers streamline back office healthcare operations. 

With our experience and specialty, you can focus on delivering quality care while we improve your revenue cycle through streamlined and optimized billing processes. The benefits of partnering with us include:

• Access to a vast pool of global talent that brings diverse experience and specialized experience in dermatology billing procedures for efficient and accurate claim management.
• Compliance with evolving regulatory requirements becomes more manageable with our team as we stay updated on the latest guidelines.
• Our collaboration guarantees cost-effectiveness by avoiding the necessity of maintaining in-house billing teams and investing in advanced technology and billing infrastructure.
• Optimize billing operations through the latest technology and best practices offered by our team tailored specifically for dermatology billing, ensuring accurate coding, timely submissions, and maximum reimbursement.

Source: freepik.com

Conclusion

Current Procedural Terminology, or CPT codes, offers healthcare professionals a uniform language. Each code represents specific procedures or services. It enables precise elaborations and classifications for dermatological interventions. 

Knowing the most common CPT codes for dermatology billing ensures providers get accurate reimbursement, efficient billing processes, and effective communication with professionals, insurers, and regulatory bodies. However, many organizations face challenges in dermatology billing due to the complexity and amount of CPT codes. Thus, our reputable outsourcing company, CLICKVISION BPO, offers tailored medical billing solutions and strategic approaches for anyone seeking effective operational efforts. Leveraging the power of outsourcing will ultimately lead to optimized billing processes, improved reimbursement, and financial stability!