Specialized billing for dermatology practices — skin biopsy coding, Mohs surgery, cosmetic vs medical billing, and dermatology revenue cycle management. Serving practices nationwide across the United States.
Get Free Practice Audit Contact UsComprehensive billing coverage for your specialty
Accurate coding for shave biopsies, punch biopsies, excisions, and coordination with pathology lab billing.
Complex Mohs micrographic surgery billing with accurate stage coding, repair coding, and reconstruction billing.
Properly separating medically necessary procedures from cosmetic ones to maximize insurance reimbursement.
Laser treatments, cryotherapy, phototherapy, destruction of lesions, and all in-office procedures accurately coded.
Dermatology denials for cosmetic vs medical necessity are appealed with clinical documentation and photographic evidence.
Monthly financial reports with procedure-level profitability and payer performance analysis.
Dermatology generates more claims per provider than almost any specialty — a busy dermatologist can produce sixty encounters a day, most involving procedures, and many involving the medical-versus-cosmetic coverage line. That volume amplifies everything: a small coding error repeated across a high-volume clinic becomes five figures of lost revenue by year-end. Dermatology billing lives or dies on lesion-level precision.
Destruction, excision, and biopsy codes are selected by lesion size (measured before excision, including margins), anatomic site, and lesion count — with add-on codes for each additional lesion and strict rules about what counts as one. Undermeasured lesions and missed add-on codes are the classic dermatology revenue leaks; miscounted ones are the classic audit trigger. Our coders work from the procedure note's documented measurements, and we push back for clarification when a note says 'several lesions removed' — because vague notes cost precise money.
Excision codes split by benign versus malignant pathology, which means the correct code often isn't knowable until the path report returns. Billing before pathology finalizes means systematic undercoding (defaulting to benign) or dangerous guessing. We hold excision claims for pathology, code from the final report, and coordinate the pathology claim itself so the whole episode bills consistently.
Payers cover destruction of premalignant lesions and medically symptomatic conditions — not cosmetic removal. Skin tags, benign nevi, and seborrheic keratoses are covered only with documented symptoms: bleeding, irritation, inflammation, obstruction. We make sure documented symptoms reach the claim as diagnosis codes, and that genuinely cosmetic work is collected as self-pay up front rather than billed, denied, and lost.
Almost every dermatology visit combines an evaluation with a same-day procedure, which makes modifier 25 a daily necessity — and payers know it, which makes dermatology a prime target for modifier 25 audits and prepayment reviews. We bill the E/M only when documentation shows genuinely separate decision-making beyond the procedure, keeping your revenue intact and your audit profile quiet. When bundling denials do land, our CO-97 playbook covers exactly how we work them.
Modern dermatology billing extends past procedures: biologics for psoriasis carry prior-authorization and step-therapy requirements, phototherapy has frequency limits and documentation rules, and practices with in-house dermatopathology need clean professional/technical component billing. Each is a distinct revenue stream with its own denial patterns — and each is included in our dermatology billing service.
Specialties that share dermatology’s lesion, biopsy and cosmetic-versus-medical coding problems.
Mohs reconstruction and the cosmetic-versus-medical determination are shared daily problems for both specialties.
Skin cancer pathways run between the two, and destruction versus excision coding decides the reimbursement.
Autoimmune skin disease brings shared biologic therapy and the prior-authorization burden that comes with it.
Nail and lower-limb skin conditions are frequently co-managed, with overlapping debridement coding.
We bill all of these in house. If your group spans several of them, multi-specialty billing keeps one team across every line — or see the full list of services.
Get a free billing audit and see how much more your skin care practice can collect.
Get Free Practice AuditFree resources: Denial Code Lookup | RVU Calculator | AR Days Calculator | Modifier 59 — multiple lesions, distinct sites