Dermatology is billed by the lesion, and that is where it goes wrong.
Counts, sizes and sites drive dermatology payment. A destruction of fourteen lesions billed as one, or a cosmetic procedure billed to insurance, are both routine and both expensive.
- 97%Coding accuracy on audit
- 50+Specialties covered
- 4.9/5Average client rating
Three ways Dermatology claims quietly lose value
Review these issues against the documentation, remittance and policy that applied on the date of service. They can appear as denials or underpayments.
- Lesion counts and sizes not captured
Excision codes depend on the excised diameter including margins, and destruction codes depend on the count. Taken from the note loosely, both underpay.
- Pathology billed by the wrong party
Whether the practice or the lab bills the specimen depends on who did what. Billed by both, one gets recouped; billed by neither, nobody is paid.
- Cosmetic work billed to insurance
A cosmetic procedure submitted to a payer is not just denied, it is a compliance problem. It needs to be quoted and collected up front.
What we bill for Dermatology practices
If something you do is not on this list, ask. We will tell you honestly whether we have the depth for it.
How Dermatology accounts are actually run
The worklist connects each claim to its documentation, payer requirements and next follow-up date.
- A dermatology coder, not a general one
The coder assigned to your account works dermatology every day. They already know which of your payers do what, and they are watching lesion counts and sizes, pathology splits and cosmetic carve outs.
- Charges checked against the note
Before anything goes out, the charge is read against the documentation. A code the note does not support is a recoupment waiting to happen, and in dermatology it is usually the highest value code on the claim.
- Eligibility and authorization ahead of the visit
Coverage is confirmed and any approval is in place before the service, not discovered afterwards when the work has already been done.
- Denials worked to cause, not just refiled
Every denial is tagged by payer and reason code. When a pattern shows up in your dermatology claims we change the upstream step so it stops recurring.
- Reporting you can act on
Monthly numbers by procedure family and payer, with the one decision they imply, rather than an export nobody opens.
Included for Dermatology practices
- Coders who work dermatology daily
- Charge review against documentation
- Eligibility and benefit verification
- Prior authorization management
- Denial management by payer and reason code
- Aged A/R worked oldest first
- Patient statements and balance follow up
- Monthly reporting by procedure family
These describe how we run the service. They are commitments about our process, not a guaranteed outcome on any individual claim.
We work inside the system you already use
We agree user permissions, claim queues, reporting access and escalation contacts in your current system before work begins.
Dermatology billing across the country
These state guides explain local Medicaid programs and payer administration. They cover general billing requirements, rather than a separate Dermatology service in each state.
Arizona payer guideAHCCCS and 7+ plans
Washington payer guideApple Health and 7+ plans
Texas payer guideTexas Medicaid and 8+ plans
New York payer guideNY Medicaid and 8+ plans
California payer guideMedi-Cal and 8+ plans
Ohio payer guideOhio Medicaid and 8+ plans
Florida payer guideFlorida Medicaid and 8+ plansWhat Dermatology practices ask
Do you code from the operative note?
Yes. Sizes and counts come from the note, not the schedule.
Who bills the pathology?
Whoever performed the technical and professional parts. We set it up once so it is consistent and defensible.
Can you keep cosmetic work separate?
Yes, on its own workflow with payment collected up front.
Do you handle biologic prior authorizations?
Yes. They are slow, and starting them late is the main reason patients go untreated.
Have a dermatology coder read your last ninety days
Tell us your specialty and the billing issue you want reviewed. We will agree the scope and arrange a secure way to share any records needed.