Dermatology Billing & CPT Coding Guide
Master dermatology coding to prevent denials and ensure maximum reimbursement.
Common Dermatology CPT Codes
- 11102 – Tangential biopsy of skin
- 11401 – Excision of benign skin lesion (0.6 to 1.0 cm)
- 17000 – Destruction of premalignant lesion (e.g., actinic keratoses)
- 17311 – Mohs micrographic surgery, first stage
- 96372 – Therapeutic, prophylactic injection
Challenges in Dermatology Billing
- Confusion between cosmetic vs. medically necessary services
- Bundled service issues (e.g., lesion removal + biopsy)
- Lack of preauthorization for covered procedures
- Improper use of modifiers (-59, -25)
Frequently Used Modifiers
- -25 – Separate E/M service on same day as procedure
- -59 – Separate service not normally reported together
- -76 – Repeat procedure by same provider
Best Practices for Dermatology Billing
- Document medical necessity thoroughly
- Stay up to date on cosmetic procedure exclusions
- Use precise size/location measurements for lesion removal
- Verify patient eligibility and prior authorization
Final Thoughts
Dermatology billing presents unique challenges due to the mix of cosmetic and medical procedures. Partnering with a specialty billing provider like Medix RCM Solutions ensures correct CPT coding, faster collections, and lower denial rates—helping dermatology practices stay focused on patient care.