What are the top reasons for denials in dermatology?

Denials stem from incorrect coding, lack of documentation, pre-authorization issues, and exceeding frequency limits.

Why outsource dermatology billing services?

Outsourcing ensures focus on patient care while professionals handle compliance and maximize revenue.

What is the value of using MBW RCM for dermatology billing?

Decades of experience, certified staff, and high compliance standards help maximize collections.

How does MBW RCM ensure compliance with regulations?

Ongoing training, audits, and adherence to HIPAA, HITECH, MACRA ensure compliance.

What is CPT in dermatology?

CPT codes describe medical procedures. In dermatology, they include excision, biopsy, cryosurgery, and lesion destruction codes.

How can dermatology clinics reduce denials?

Accurate documentation, regular audits, and pre-authorization are key strategies.

How often are dermatology billing codes updated?

CPT codes are updated annually. Staying informed ensures billing compliance.

Does dermatology require prior authorization?

Many procedures, especially cosmetic or surgical, may require prior authorization.

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Home > Medical Specialties > Dermatology Billing Services

Dermatology Billing Services

Dermatology billing can be intricate and complicated as it has evolved immensely over the years. It requires a clear description of skin lesions, including the size, the number, and the precise location. Dermatology billing also requires detailed information on the biopsy, excision, and lesion destruction.

In addition to the constantly changing patterns of insurance and reimbursement policies, dermatology has also changed rapidly. Dermatology has expanded beyond medical and surgical. It now includes a variety of cosmetic surgeries.

A dermatology practice requires implementing technology, seamless processes, and performance against several service lines to avoid being under-compensated or deal with audits & fines. Outsourcing to a seasoned service provider gives you access to a team of professionals trained in end-to-end billing for dermatology.

MBW RCM’s Expertise in Dermatology

Our team of medical billing and coding professionals is competent in understanding the unique attributes of dermatology billing. We have a client base that extends over 50 states covering a wide range of hospitals, physician practices, and medical billing companies. Our coders are proficient in ICD-9/10, CPT, HCPCS coding based on CMS and AMA guidelines and are certified by the American Academy of Professional Coders (AAPC).

Applying best practices for Dermatology Billing

Our team understands global surgical packages for Dermatology, including a preoperative visit on the day before significant surgeries or the day of minor surgeries, intraoperative services, postoperative care, supplies, wound care, and postoperative complications. We are also well-versed in the CPT codes provided by CMS for each procedure and their global periods.

Our expertise in Dermatology includes but is not limited to:

Medical Dermatology
Surgical Dermatology
Pediatric Dermatology
Cosmetic Dermatology
Dermato-immunology
Dermatopathology and Oral Pathology Laboratory
Photomedicine (Phototherapy & Photopheresis)

Our Value

We employ our extensive experience gained over decades of supporting Dermatology practices. MBW RCM can reduce your staffing and administrative expenses, increase revenue, and ensure compliance with all standards with additional benefits.

Certified by The American Association of Professional Coders (AAPC) and has received training in most common Medical Coding Software
Successful in processing medical claims with most commercial insurance companies including UHC, WellPoint, Aetna, Humana BCBS, and Anthem, and government payers such as Medicare
Successful in working with Medicare and understand state-specific Medicaid Policies
We reduce costs and help you achieve improved clinical and operational efficiency

FAQs on Dermatology Billing Services

Dermatology medical billing refers to the process of coding and submitting insurance claims for dermatological procedures such as biopsies, excisions, and cosmetic treatments, using CPT, ICD-10, and HCPCS codes.

Frequently used CPT codes include:
- 11100–11101: Skin biopsies
- 11400–11446: Excision of benign lesions
- 17000–17004: Destruction of premalignant lesions
- 17311–17315: Mohs surgery

Modifier 24 is used to indicate an unrelated evaluation and management service by the same physician during a postoperative period. It helps dermatologists get paid for separate concerns addressed outside of a global procedure.

Challenges include frequent changes in payer policies, bundling of procedures, cosmetic vs. medical coverage issues, and the complexity of modifier use, especially with biopsies and lesion removals.

Improve denial management by ensuring pre-authorizations, using accurate documentation, applying correct modifiers, and following up on rejections promptly. Outsourced billing teams can streamline this process.

Yes, cosmetic procedures (e.g., Botox, cosmetic mole removal) are often not covered by insurance, while medically necessary treatments (e.g., skin cancer removals) are. Clear documentation justifying medical necessity is key.

MBW RCM offers dermatology-specific billing solutions including accurate coding, pre-authorization support, denial resolution, and compliance monitoring to ensure timely reimbursement and optimized revenue cycles.

Margins vary by location and procedure type, but on average, dermatology practices may see profit margins ranging from 20% to 40%, with cosmetic-focused practices typically earning higher margins.

Benefits of Our Dermatology Billing Services

Supporting a wide range of hospitals, physician practices, and medical billing companies across 50 states
Our coders are certified by the American Association of Professional Coders (AAPC), proficient in ICD-9/10, CPT, HCPCS coding.
Understanding all aspects of global surgical packages, including preoperative visits, intraoperative services, and postoperative care.
Proprietary workflow and reporting tools to enhance efficiency and accuracy.
Successfully processing claims with a variety of insurance companies including UHC, WellPoint, Aetna, Humana BCBS, Anthem, and government payers like Medicare.
Maintain compliance with healthcare regulations and minimize legal risks.