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Tips for dermatology medical billing and coding

Jul 27

Dermatologists play an important part in providing healthy skin to everyone. Due to dermatologists, there is a decrease in skin diseases and disorders, and Dermatology has even reduced skin cancer among the masses. 

Yet dermatology medical billing is challenging because the medical industry of the US is changing quickly. to run a successful dermatology practice, one has to act proactively to know changes occurring in dermatology medical billing. Due to hefty paperwork and documentation, the process becomes difficult, and that is many practices tend to outsource medical billing services from third parties like Ucontrol Billing. 

If you want to streamline your practice medical credentialing services to save time and cost, keep reading for the tips that would benefit you! 

Why Is Efficient Dermatology Medical Billing Necessary? 

To get reimbursed maximum for dermatology services, one must have an accurate and efficient medical billing process. All medical specialties must ensure that their medical billing process is intact and accurate to get payments for the treatments they provide. Still, dermatology medical billing requires extra care to ensure their medical billing is top-notch. To have a proper dermatology medical billing process, it is important to pay attention to compliance guidelines and modifiers. 

Dermatology includes numerous services and procedures. It includes simple procedures and complex surgeries to treat different skin conditions; its medical billing is also very complex. Dermatologists have to see and treat numerous patients daily, so they require precise dermatology medical billing and coding process to help them get proper compensation for their services! 

Some Amazing Tips To Improve Dermatology Medical Billing 

Here are some tips that can help dermatology practice to have an accurate and efficient medical billing process: 

Keep An Eye On Patient Insurance.

Regular patients are usually relucted to share their information again or provide their insurance detail and card each time they visit. But to ensure that patient insurance is liable, one must check and verify patient insurance information each time they come for their appointment. This will help the dermatology practice handle things properly with their insurers. 

Ensure Timely Claim Submission

It is long and time-consuming work to get reimbursed fully from the payer, so it is important to submit claims on time. When one submits a claim on time, they increase their chances of being fully reimbursed for their services. To submit a claim on time, make sure that this is the priority of your billing staff. 

Have a Good Claim Rate 

Having a clean claim ratio is important because a claim ratio under 95% means that your practice is not earning revenue and is actually losing it. The claim ratio implies the average number of claims paid in the first submission. If your claim ratio is low, you might increase your expenses because your staff will have to spend more time, money and energy to eliminate errors and edit the rejected claims. If you want to ensure less expensive and save valuable time for your staff, ensure that you have a clean claim rate. 

Collect Co-Pays at Time of Service

If you want a billing process that does not cost you bucks, ensure that your practice has an efficient way to determine the co-pay that patients owe you before providing the service. Make it official to get advance payment and set us a front desk that can deal with the patients who refuse or reluct to pay in advance. 

Keep Track & Follow-Up of Unpaid Claims

It is important to keep track of the submitted claims to know what you are being paid for and what it is that you are not being paid for. Also, it is essential to follow up on the claim that takes longer than 60 days to be paid before deciding to resubmit it because usually, it is just about a single phone call to get your claims handled by the payer! 

Stay updated with the changes in Modifiers. 

Modifiers in dermatology medical billing have a critical role, and any error in their usage can cause your billing process to trip. To ensure that none of our claims are delayed or denied, ensure that your medical billing and coding staff uses modifiers correctly and keeps up with the changes that occur frequently. We have collected some of the most important modifiers that medical billing service providers should watch for! 

Modifier 25

This modifier is used with the patient associated with the practice and is usually used with  E/M CPT codes. This modifier should not be used for new patients or with other CPT codes. 

Modifier 59

This modifier is used with dermatology CBT codes to refer to the services and procedures that were different from those provided on the same day. 


It includes the following: 

XP – A different service or procedure that some other provider performs

XE – A different service that is provided in a distinct encounter

XS – A different service  that is performed on a different structure or organ

XU – A service that is separate because it doesn’t overlap the main service 

Tips For Dermatology Coding:

To get the best dermatology coding, it is important to ensure that it is accurate and error-free. If you want the best coding, try to avoid these common errors:

  • Know that a biopsy, a shave and an excision are different. 
  • Avoid overbilling for excursions.
  • Avoid under-billing for re-excursions 
  • Know the correct usage of modifiers
  • Submit claims only when the pathology report is reviewed 
  • Avoid upcoding
  • Avoid under coding


Outsource Your Dermatology Medical Billing

Medical billing and coding processes of every specialty, including dermatology, are becoming complex because of constant changes in the rules and regulations. It requires a lot of time and energy from the medical staff, so it is better to entrust these processes to a third party to manage your dermatology billing. The practice realizes its potential when medical billing services are outsourced and gets efficient billing and coding processes. 


Let us Wrap it up!

Dermatology medical billing is complex like other processes. It has become complicated because of the immense changes that have occurred over time. In addition, dermatology billing and coding require correct documentation, detailed information and codes for different services and procedures. Dermatology deals with medical and cosmetic surgeries and has a complex medical billing process. To get reimbursed fast, follow the tips we have talked about or try outsourcing to a seasoned service provider like UControl billing that will provide you with a team of professionals trained in end-to-end dermatology billing. UControl Billing is one of the best medical billing companies because they provide timely follow-ups and 24-hour billing services. By partnering up with them, you would not have to worry about billing and coding; instead, you can focus on what is more important: Patient Care!