Blepharoplasty Coding Information & Procedure

Here are the diagnosis codes typically associated with medically necessary blepharoplasties.  We also provide some helpful dermatology coding tips in making Medicare or your insurance carrier cover your procedures. Prior to performing a blepharoplasty, the patient would need to have a visual examination by either an Optometrist or Ophthalmologist.  E&M Codes: 92081-92083 (Visual Examination, unilateral…

Helpful Modifier Information

Modifiers are a critical component of coding and using them incorrectly will result in lost revenue and possible audits.  Know your modifiers and reduce the risk of lost revenue and improve compliance.  Below you will find a brief overview of common modifiers used in medicine.  Modifier guidelines continue to change so you should always have the most recent copy of the CPT book produced by the AAPC or AMA.

Modifier 22: Increased procedural services
This modifier will most likely trigger an audit, so we recommend avoid using modifier 22 unless there is no CPT code describing the increased work.  Clear documentation must support the increased service and give reason for any additional work (i.e. increased intensity, time, technical difficulty, severity of patient’s condition, etc).  Do not append modifier 22 to an E/M service.

Incision & Drainage Coding

Billing and coding for I&Ds is something performed in nearly every Dermatology office in the country.  We have included a brief overview of the codes used and some common edits that will help get your incision and drainage claims paid the first time through.

 

CPT codes 10060/10061, 10080/10081, 10120/10121, 10140, 10160 and 10180

Code Descriptions
10060 I & D of abscess (cutaneous or subcutaneous abscess, cyst, or paronychia); simple or single
10061 I & D of abscess (cutaneous or subcutaneous abscess, cyst, or paronychia); complicated or multiple
10080 Incision and drainage of pilonidal cyst; simple
10081 Incision and drainage of pilonidal cyst; complicated
10120 Incision and removal or foreign body, subcutaneous tissues; simple
10121 Incision and removal or foreign body, subcutaneous tissues; complicated
10140 Incision and drainage of hematoma, seroma or fluid collection
10160 Puncture aspiration of abscess, hematoma, bulla, or cyst

Exicision Coding Guidelines

According to the CPT 2008 guidelines, you should not be coding for the excision when utilizing performing simple-complex repairs using your typical excisional codes. In 2008 CPT Professional Edition, page 58, top of 2nd column, paragraph 2. When multiple wounds are repaired, add together the lengths of those in the same classification and from all…

Starting a Successful Dermatology Practice

Dermatology Practice Start Up Help There are many things that require your attention when starting a dermatology practice and for those of you who have done it, you understand what I mean. Starting a new practice has to be one of the most stressful and trying times for a physician. It would seem as though…

Check Destruction Coding Method

To combat this economic downturn Dermatologists must be keenly aware of how they are coding and if they are leaving money on the table. Treating 17110 as your practices catch-all skin lesion destruction procedure code could cut $30-$72 from a claim-but there is an easy way to avoid this trap.

“Destruction” is a broad term that means ablation of tissues or lesions. The term encompasses any method such as; scrapping, burning, chemical, laser, etc., but some methods are code specific. Understanding how to correctly code for skin lesion destruction becomes more important. Double check whether your dermatologist is providing other services that could benefit your bottom line, and know how to code accordingly.

Get to the bottom of Shaving Lesions

Question: A dermatologist destroys 13 molluscum contagiosums on a patient and shaves a 0.4 cm mole on the patient’s upper arm. Should you use only 17110?

Gross and Net Collection Ratio

Gross Collection Ratio

The gross collection ratio includes the total payments received by a practice for a specific period without any write-offs. The gross collection ratio is the total payments for the period divided by the total charges without write-offs. For example, $500,000 (your payments) divided by $1000,000 (your charges), equals a gross collection rate of 50 percent. This means that for every dollar charged, the practice is collecting 50 cents. This is not a good ratio; however, it may be the best the office can do if the practice has a high payor mix consisting of Medicaid, and Medicare. This is obviously dependent upon how the charges are set as a percentage of current Medicare.


Net Collection Ratio