Dermatology practices often deal with claim denials and with rising medical audits that result in far greater complexities. Dermatology billing is considered a demanding by billers as it renders complicated tasks for medical, surgical, and cosmetic procedures resulting in delay or no reimbursement. Legion Healthcare Solutions (LHS) understand the complexities involved in dermatology billing, it’s estimated that a dermatology claim on average might consume about 12 hours of week for paperwork and coding.

The rising dermatology guidelines is another challenge every clinic has to go through with new guidelines involving a change in the documentation for E/M with a focus on time, course of nature for presenting the problem and counselling. Current guidelines involve medical decision-making, examination, and history.

“With any medical billing company that accepts any dermatology client, there is a constant impetus on medical procedures that are required even before the patient usually arrives. The documentation is usually detailed and does the new treatment require regular medical visits or drug. The new billing guidelines are built to improve the decision making for both payer and dermatologists.”

-Billing Manager at LHS

LHS constantly keeps updating based on new dermatology guidelines, in 2021 dermatology coding stated that healthcare professionals should be able to capture the accurate and appropriate history and examinations performed.

During patient examination by the care team, all the information from the patient should be directly sent to healthcare professionals, this is imperative because during code section level the time frame is considered.

In case of any dermatology coding, medical decision-making is imperative as it helps in calculating the level of service. The complexity of addressed problems, the complexity of reviewed, and analyzed data, risk of complications and morbidity along with management.

If under the supervision of qualified staff a reporting service is performed by clinical staff, CPT code 99211 is to be used for dermatology coding.

For coding beyond the established time frame, new codes are introduced that include 99205 and 99215.

Modifiers can sometimes cause overpayment, as per CMS certain procedures should include in the procedure code. To avoid such coding errors billers and coders evaluate the document before sending it to the payer.

Coding changes in dermatology have been frequent and regular leading to confusion on both payer and biller side. LHS has quarterly upgrade sessions for all certified coders.

Dermatology practice is just not medical consultation but even involves surgical procedures that may require additional procedure coding. Documentation is necessary for such a condition to determine the underlying medical condition before surgery, LHS medical experts are constantly in touch with insurance companies and a dermatologist for all Prior Authorization.

To reduce the risk of denials or delays in our AR days, LHS uses modern-day analytics solutions to monitor each claim in the process. LHS aims to keep AR days below 60.

API-and RPM-based technology will help the dermatology centre improve the patient experience.