CPT Coding and Reimbursement Issues in Dermatology


CPT Coding and Reimbursement Issues in Dermatology

Vol. 24. No. 3
James A Zalla, MD

In the past 6 years, significant changes have been made in Current Procedural Terminology ® codes, descriptors, and guidelines affecting dermatologists. These changes involved excision, repair, measuring excised diameter, measuring flap defects, skin biopsy and Mohs surgery guidelines, KOH examination, and fungus cultures. New codes were introduced for photodynamic therapy, laser treatment, and whole-body photography. Reimbursement issues affecting dermatologists are also discussed, including inappropriate bundling of separate services, failure to recognize modifiers, and unfair multiple procedure reduction. The successes of the American Academy of Dermatology Association advocacy efforts with insurance carriers are summarized, with an update on the current status of these issues. Physician responsibilities, documentation requirements, and expectations are also outlined.

Semin Cutan Med Surg 24:117-123 © 2005 Elsevier Inc. All rights reserved.