Category: CC-Dermatology

Incident-To Billing
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Incident-To Billing

September 5, 2019 Question: Our physicians have instructed us to bill under a physician’s NPI number for all Advanced Practitioners (PA’s and NPs) for all patients for Medicare as we follow incident-to billing. We have been submitting claims for all new and established patient visits regardless of whether there is a physician in the office....

Mohs Staging
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Mohs Staging

August 8, 2019 Question: My physician performed Mohs surgery on a patient with a basal cell carcinoma on his cheek. He took the first stage with 6 tissue blocks, but does cancer is still evident in the margins based on the mappings. A second stage is removed with 4 tissue blocks. The second stage shows...

Confirmation Pathology Report
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Confirmation Pathology Report

July 11, 2019 Question: Can we perform Mohs surgery without a pathology report? Answer: If you review CMS and other payor policies they all require a recent pathology report usually no more than 3 months old confirming the malignancy prior to performing Mohs surgery. *This response is based on the best information available as of...

Modifier 59
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Modifier 59

June 20, 2019 Question: I destroyed 8 AKs and 3 SKs on a patient and also took a shave biopsy of another site.  My codes are 17000, 17003 X 7, 17110, and 11102.  Do I use modifier 51 or 59?  I get confused on this issue. Answer: Since there are bundling edits for the codes...

Diagnosis Code
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Diagnosis Code

June 6, 2019 Question: A pathology report came back from a skin biopsy stating “compound dysplastic lesion with severe atypia.  Re-excision recommended.”  Should the diagnosis code be D48.5 for lesion of uncertain behavior of the skin be assigned, or a benign code since it does not state it is malignant? Answer: Since the pathology notes...

Ear Biopsy
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Ear Biopsy

May 23, 2019 Question: What is the correct code for a tangential biopsy of the antihelical fold?  I was going to bill 11102, but I was told that there are different codes in other sections of CPT for some biopsies. Answer: The correct code would be 69100, Biopsy external ear.  As a bonus, this correct...

Skin Tag Removal by Shave
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Skin Tag Removal by Shave

May 9, 2019 Question: If I remove 3 small skin tags (less than 0.5cm) by shave technique from a patient’s neck, can I bill 11305 with three units due to the technique? Answer: No.  According to CPT, the skin tag removal codes 11200-11201 are for removal of skin tags “by scissoring or any sharp method,...

Modifier 50 for ATT?
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Modifier 50 for ATT?

April 25, 2019 Question: My doctor did two adjacent tissue transfers, one on the abdomen and one on the each leg of the patient.  He wants to bill 14020 with modifier 50, but I don’t think that is correct.  Help. Answer: CPT code 14020 has an indicator of “0” for bilateral procedures, which means that...

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