Consultation with specialist before procedure for treating the walls of the uterus, the doctor uses a mock-up of the uterus
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
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
Note: Always verify codes with current AMA CPT guidelines and insurance payer requirements. This cheat sheet is for reference only.
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.
