Navigating dermatology billing can be tricky, but having the right codes at your fingertips can make all the difference. With the growing demand for dermatological services, ensuring your billing process runs smoothly is key to getting reimbursed quickly and avoiding costly claim denials.
Why Your Dermatology Practice Needs a Billing Cheat Sheet
Dermatology medical billing presents unique challenges due to the vast array of skin conditions and procedures performed. With hundreds of CPT codes to navigate and frequent updates to billing regulations, even experienced billing staff can struggle to keep pace.
A comprehensive cheat sheet of frequently used dermatology CPT codes serves as a quick reference tool that your billing department can easily use while submitting information to insurance providers. This resource not only streamlines the billing process but also helps reduce errors that could lead to claim denials.
Essential Dermatology CPT Codes for 2025
Let’s explore the most commonly used CPT codes organized by category to help your dermatology practice optimize its billing efficiency.
Evaluation and Management (E/M) CPT Codes
| CPT Code | Description | Time/Complexity |
| New Patient | ||
| 99202 | Office/outpatient visit, new patient | 15-29 minutes, straightforward |
| 99203 | Office/outpatient visit, new patient | 30-44 minutes, low complexity |
| 99204 | Office/outpatient visit, new patient | 45-59 minutes, moderate complexity |
| 99205 | Office/outpatient visit, new patient | 60-74 minutes, high complexity |
| Established Patient | ||
| 99212 | Office/outpatient visit, established patient | 10-19 minutes, straightforward |
| 99213 | Office/outpatient visit, established patient | 20-29 minutes, low complexity |
| 99214 | Office/outpatient visit, established patient | 30-39 minutes, moderate complexity |
| 99215 | Office/outpatient visit, established patient | 40-54 minutes, high complexity |
Skin Biopsy CPT Codes
| CPT Code | Description |
| 11102 | Tangential biopsy of skin; single lesion |
| 11103 | Tangential biopsy of skin; each additional lesion |
| 11104 | Punch biopsy of skin; single lesion |
| 11105 | Punch biopsy of skin; each additional lesion |
| 11106 | Incisional biopsy of skin; single lesion |
| 11107 | Incisional biopsy of skin; each additional lesion |
| 40490 | Biopsy of lip |
| 69100 | Biopsy of external ear |
Destruction/Lesion Removal CPT Codes
| CPT Code | Description |
| 17000 | Destruction of premalignant lesion (e.g., actinic keratoses); first lesion |
| 17003 | Destruction of premalignant lesions; 2-14 lesions |
| 17004 | Destruction of premalignant lesions; 15 or more lesions |
| 17110 | Destruction of benign lesions (not skin tags); up to 14 lesions |
| 17111 | Destruction of benign lesions (not skin tags); 15 or more lesions |
Mohs Micrographic Surgery CPT Codes
| CPT Code | Description |
| 17311 | Mohs technique; head, neck, hands, feet; first stage |
| 17312 | Mohs technique; head, neck, hands, feet; each additional stage |
| 17313 | Mohs technique; trunk, arms, legs; first stage |
| 17314 | Mohs technique; trunk, arms, legs; each additional stage |
Excision of Lesions CPT Codes
| CPT Code | Description |
| Benign Lesions | |
| 11400 | Excision benign lesion; trunk, arms, legs; 0.5 cm or less |
| 11401 | Excision benign lesion; trunk, arms, legs; 0.6-1.0 cm |
| 11402 | Excision benign lesion; trunk, arms, legs; 1.1-2.0 cm |
| 11403 | Excision benign lesion; trunk, arms, legs; 2.1-3.0 cm |
| 11404 | Excision benign lesion; trunk, arms, legs; 3.1-4.0 cm |
| Malignant Lesions | |
| 11600 | Excision malignant lesion; trunk, arms, legs; 0.5 cm or less |
| 11601 | Excision malignant lesion; trunk, arms, legs; 0.6-1.0 cm |
| 11602 | Excision malignant lesion; trunk, arms, legs; 1.1-2.0 cm |
| 11603 | Excision malignant lesion; trunk, arms, legs; 2.1-3.0 cm |
| 11604 | Excision malignant lesion; trunk, arms, legs; 3.1-4.0 cm |
Wound Repair CPT Codes
| CPT Code | Description |
| Simple Repair | |
| 12001-12007 | Simple repair of superficial wounds |
| Intermediate Repair | |
| 12031-12037 | Intermediate repair; scalp, trunk, extremities |
| 12041-12047 | Intermediate repair; neck, hands, feet, genitalia |
| 12051-12057 | Intermediate repair; face, ears, eyelids, nose, lips |
| Complex Repair | |
| 13100-13102 | Complex repair; trunk |
| 13120-13122 | Complex repair; scalp, arms, legs |
| 13131-13133 | Complex repair; forehead, cheeks, chin, mouth, neck |
Pathology CPT Codes
| CPT Code | Description |
| 88304 | Level III – surgical pathology, gross & microscopic exam |
| 88305 | Level IV – surgical pathology, gross & microscopic exam |
| 88312 | Special stain including interpretation and report |
| 88341 | Immunohistochemistry or immunocytochemistry |
Laser Therapy and Phototherapy CPT Codes
| CPT Code | Description |
| 96900 | Actinotherapy (UV light) |
| 96910 | Photochemotherapy; tar and ultraviolet B |
| 96913 | Photochemotherapy (PUVA) |
| 96920 | Laser treatment for inflammatory skin disease; < 250 sq cm |
| 96921 | Laser treatment for inflammatory skin disease; 250-500 sq cm |
| 96922 | Laser treatment for inflammatory skin disease; > 500 sq cm |
| 96567 | Photodynamic therapy for premalignant/malignant lesions |
| J7308 | Aminolevulinic acid HCL for topical administration |
Common Dermatology Modifiers
| Modifier | Description | Use Case |
| 25 | Significant, separately identifiable E/M service by the same physician on the same day | Used when a patient comes in for a procedure but also has a separate, billable issue requiring evaluation |
| 51 | Multiple procedures | Used when multiple surgical procedures are performed during the same session |
| 59 | Distinct procedural service | Used when procedures that are not normally reported together are performed during the same session |
| 57 | Decision for surgery | Used when an E/M service resulted in the initial decision to perform surgery |
| 79 | Unrelated procedure during postoperative period | Used for procedures unrelated to a previous procedure’s global period |
| XS | Separate structure | Used to denote a service performed on a separate organ/structure |
Common Billing Errors in Dermatology
Dermatology billing errors can significantly impact your dermatology practice’s revenue cycle and cash flow. Some frequent mistakes include using outdated CPT codes, insufficient documentation to support medical necessity, improper modifier usage, and unbundling services that should be billed together. These errors often lead to claim denials, delayed payments, and potentially costly audits.
When to Consider Outsourcing Dermatology Billing
By outsourcing your dermatology billing, dermatologists can focus on their work, instead of getting bogged down with claims and denials. Your billing staff can save time and energy which leads to increased staff satisfaction and productivity; dermatologists can ensure they are meeting compliance standards; patients benefit from efficient and accurate treatment and bill processing; and ultimately your practice will realize its true revenue potential.
Need More Assistance? Contact us today to optimize your dermatology billing and improve your practice’s efficiency.
Disclaimer: This cheat sheet is for informational purposes only and does not constitute legal or financial advice. CPT codes are subject to change; always verify with current AMA guidelines and your specific insurance carriers before submitting claims. This resource should be used as a reference tool only and not as a substitute for professional coding advice.