Specialty billing
Dermatology Billing Services
Dermatology coding depends on technique, size and pathology. It also depends on keeping medically necessary care clearly apart from cosmetic work.
Rules to watch
- Modifier 25 when an E/M and minor procedure occur together
- Final pathology before coding malignant excisions
- Repair codes billed with excisions
- Destruction codes by lesion type and number
- Advance notices for non-covered services
What makes dermatology billing tricky?
Dermatology billing depends on details that only show up after the visit. Whether an excision is coded as benign or malignant depends on the pathology report, and the code also depends on the excised diameter, including margins, and the body area. Biopsies have had their own codes by technique since 2019: tangential, punch or incisional. Many visits mix medical and cosmetic work, and cosmetic services are not billed to insurance at all. Add modifier 25 for a separate exam on the same day as a procedure, and there are plenty of ways for a claim to go wrong. Waiting for pathology before coding excisions, and recording lesion size and location clearly, prevents most of it.
What makes it different
What makes dermatology billing different
Codes at a glance
Common dermatology codes and what to watch
| Service | Codes | What to watch |
|---|---|---|
| Biopsy | 11102 tangential, 11104 punch, 11106 incisional (+11103, +11105, +11107 each additional) | First lesion coded by technique |
| Destruction, premalignant lesions | 17000 (first), +17003 (2–14), 17004 (15 or more) | 17004 is not billed with 17000 or 17003 |
| Excision, benign | 11400–11471 | Size includes margins; code after pathology |
| Excision, malignant | 11600–11646 | Code after pathology confirms malignancy |
| Mohs surgery | 17311–17315 | Stages and tissue blocks documented |
Related services
Services that matter most for dermatology
FAQ
Dermatology billing questions
Should excisions wait for pathology before coding?
Generally, yes. Whether an excision is coded as benign or malignant depends on the pathology result, so coding before it is available risks errors.
Can an office visit be billed with a biopsy?
Yes, but only when a significant, separately identifiable E/M service is documented beyond the usual pre-procedure evaluation. That visit is typically reported with modifier 25.
Can you work inside our dermatology EHR?
Yes. We bill from the dermatology EHR or practice management system you already use, with access your practice controls. Many dermatology EHRs have their own pathology and procedure templates, so we check how yours sends charges before we start.
Coding rules change every year. The code references on this page reflect general guidance at the time of writing. Payer policies and your documentation always determine what is billable.
Let’s take a closer look at your revenue cycle
Tell us what’s getting stuck. Denials, old A/R, credentialing, reports nobody reads? We’ll look at how you work now and tell you straight what we’d change, and why.