Dermatology Billing Services

Lesion destruction, Mohs stages and the cosmetic-versus-medical line, coded so the claim survives review.

Dermatology denials are nearly always a coding decision, not a payer problem. A lesion billed by the wrong method. A biopsy billed without the right add-on. A cosmetic procedure sent to insurance. Our dermatology billing services code from the operative note, because size, site, method and margins each change the CPT.

Groups looking at dermatology medical billing services usually have two other problems as well. Mid-level visits get billed incident-to when the rules were not met. And Mohs stages get billed without the pathology the surgeon actually did. We set both rules, payer by payer, at go-live.

Our Services

Dermatology Needs Its Own Skill Set

Dermatology billing takes two things: knowing the systems, and understanding what actually happens clinically. Our dermatology billing services give your practice a team that has both.

Key Attributes of Our Medical Billing Services:

  • Charge Entry

    We hold accuracy above 98% within 24 hours. We get there by automating the routine steps, handling patient data carefully, checking eligibility and talking to insurers quickly.

  • Claim Scrubbing

    We check each claim for missing information, fix what is incomplete, and resubmit anything that comes back rejected.

  • Insurance and Rejection

    We follow up with each insurer on their own payment schedule. The target is under 20% of your AR in the 60-day bucket and under 10% in the 120-day bucket.

  • Payment Posting

    Benefits, patient payments and insurance payments all go into our billing software, so your accounts receivable records stay accurate.

  • Patient Statements

    We dispatch personalized statements to patients who have outstanding balances on their accounts.

    Illustration of a doctor writing a prescription for a patient

  • Optimize Efficiency

    Assist your staff in handling the complete practice workflow, encompassing patient management, document uploads, and secure message delivery.

  • Timely Claim Submission

    Claims go to the insurer within 48 hours of us receiving the encounter form, on paper or electronically.

  • Reporting

    The weekly scorecard shows revenue booked, collected and outstanding, plus more. Ask for a different report and we will build it.

Dermatology-specific considerations

When Your Current Biller Does Not Know Dermatology

If your current billing provider does not really know dermatology codes, it costs you money. The details in this specialty are easy to get wrong, and the effects show up later, in denials and write-offs.

  • Cool Sculpting
  • Laser Treatments
  • Vein Therapy
  • Photodynamic Therapy
  • Fillers & Injections
  • Skin Cancer Treatment
  • Laser Hair Removal
  • Tattoo Removal
  • Microdermabrasion & Chemical Peels

Lesion coding is where dermatology revenue is decided

Dermatology has a small number of high volume procedures, and almost all of the coding risk is in how a lesion was treated and how it was measured.

Measure before you cut

Excision codes are chosen on the size of the lesion plus the margins taken, and on the anatomic site. That measurement has to be made and recorded before excision, because the specimen shrinks in fixative and the pathology report will not match.

A practice that codes from the pathology measurement is undercoding nearly every excision it performs. This is the single most valuable habit to fix in a dermatology office.

Benign, malignant and what closes it

Benign and malignant excisions have separate code families, so final coding waits for pathology. Closure is separate again. A simple closure is included in the excision. An intermediate or complex repair is billed on top, and it has to be described in the note in terms that support it: layered closure, undermining, extensive debridement.

Destruction is not excision

Cryotherapy, electrodesiccation and curettage are destruction codes, billed by lesion count and by whether the lesion was benign, premalignant or malignant. Premalignant lesions have their own counting rule, where the first lesion and the additional ones are billed differently. Billing a destruction as an excision, or counting lesions wrongly, is the most common error we correct in this specialty.

Mohs surgery

Mohs is billed by stage and by the number of tissue blocks in each stage, and the surgeon must be acting as both surgeon and pathologist. Pathology is not billed separately for the Mohs tissue itself. A separate specimen from a different site, sent out, is a different matter and is billable.

Cosmetic and medical in one visit

When cosmetic work and medical work happen in the same appointment, the cosmetic part is the patient's responsibility and needs a signed estimate before it is done. Sending a cosmetic procedure to insurance to see what happens is not a strategy, and it is the kind of pattern that attracts attention.

Dermatology Credentialing and Mid-Level Enrollment

Most dermatology groups run on mid-levels. That is where credentialing goes wrong. An NP or PA seeing patients under your practice still needs their own payer enrollment. They also need their own link to the group contract. Until that link is active, their visits usually cannot be billed as in network. Billing them under the supervising dermatologist instead is the classic incident-to error, and it turns into a refund demand.

Mohs surgery adds a second layer. Some payers only pay fellowship-trained surgeons. Others ask the surgeon to attest that they acted as both surgeon and pathologist. If you run your own histology lab, that lab needs a CLIA certificate and its own enrollment before you can bill the technical component.

We handle dermatologist and mid-level enrollment, group linking and the lab side together. See our medical credentialing services.

Neighbouring specialties often share codes, payers and denial patterns. See how we bill for them too, or browse every specialty we bill for.