Home | Dermatology Medical Billing
Dermatology Medical Billing: Biopsies, Excisions and Mohs Coded Right
Procedures, Pathology and Cosmetic vs Medical Care
Dermatology claims depend on details: lesion size, location, pathology results and whether a service is medical or cosmetic. Coding an excision before the pathology report is back, or missing a margin, can cost you money. Billing Benefit handles dermatology billing so every biopsy, excision and procedure is coded from complete information.
Common Dermatology Billing Problems We Fix
| Billing problem | Why it costs you | How we fix it |
|---|---|---|
| Excisions coded before pathology | Benign and malignant excision codes pay differently | We wait for the pathology report and code the final diagnosis |
| Excision size measured wrong | Excision codes are based on the lesion diameter plus the narrowest margins | We confirm documented size and margins before choosing the code |
| Biopsy codes used wrong | Tangential, punch and incisional biopsies each have their own codes and add-ons | We code each biopsy by method and count extra lesions with add-on codes |
| Cosmetic services billed to insurance | Insurers do not pay for cosmetic procedures | We separate cosmetic from medical care and use an ABN or self-pay when needed |
| Destruction codes mixed up | Premalignant, benign and malignant destruction use different code families | We match destruction codes and units to the lesion type and count |
Dermatology Codes We Handle
Office procedures and surgery
We code skin biopsies (11102-11107), benign and malignant lesion excisions (11400-11646) with repairs, destruction of premalignant lesions such as actinic keratoses (17000, 17003, 17004), Mohs micrographic surgery (17311-17315), shave removals, intralesional injections, phototherapy and office visits with modifier 25 when a separate problem is addressed.
How We Keep Dermatology Claims Clean
Code from the complete record
We match procedure notes with pathology reports, check lesion sizes, sites and repair types, and scrub claims for bundling edits before they go out. Our denial management team appeals unfair denials, and we keep your providers enrolled through our credentialing services.
Payer Rules Dermatology Practices Should Watch
Medical necessity and frequency
Payers cover removal of benign lesions only when there is a medical reason, such as bleeding, irritation or suspicion of cancer, and that reason must be documented. Mohs surgery and destruction services are audited for frequency and documentation. Medicare patients should sign an Advance Beneficiary Notice before services that may not be covered. See our guide to modifier 59.
Why Dermatology Practices Choose Billing Benefit
Coders who know the skin
You get coders familiar with dermatology procedures, close follow-up on every open claim, and monthly reports by provider and procedure. Want to see where your practice is losing revenue? Start with a free medical billing audit, or see all the specialties we bill for.
Dermatology Billing FAQs
Should excisions be coded before the pathology report comes back?
It is best to wait. Benign and malignant excision codes are different, so coding from the final pathology diagnosis avoids corrected claims and underpayments.
How is excision size measured?
Excision codes use the excised diameter: the largest diameter of the lesion plus the narrowest margin on each side. Both the lesion size and the margins should be documented before the excision.
Can an office visit be billed with a biopsy?
Only when the visit is significant and separately identifiable, such as evaluating other problems. The decision to biopsy is part of the procedure. When a separate visit is billed, it gets modifier 25.
Do you bill cosmetic dermatology?
We help you separate cosmetic services from covered medical care, collect payment for cosmetic work directly from patients, and use an Advance Beneficiary Notice for Medicare patients when coverage is uncertain.
Not Sure Where Your Revenue Is Leaking?
Get a free, no-obligation medical billing audit. We review your claims, denials and A/R, then show you what to fix first.
