SpecialtiesMedical specialties
How we see dermatology billing.
Reviewed by the VisMed medical specialties billing team
A dermatology encounter routinely produces several billable procedures: biopsies, destructions, excisions, repairs. Each is coded by the number of lesions, their size including margins, the anatomical site and the method, with modifiers for multiple procedures and for the visit that led to them. Small errors in measurement or counting repeat across hundreds of encounters a month.
Beside the medical work sits cosmetic work that must be kept entirely separate, pathology that may be billed in-house or referred, biologics for psoriasis and eczema with their authorization economics, and Mohs surgery with its own stage-based coding and repair rules.
VisMed staffs dermatology with coders who work lesion coding all day, gives you templates that capture size and site at the point of care, reconciles every specimen to a pathology claim, and runs a biologic desk for the injectable population.
Where dermatology practices lose money
The patterns we find in the aging and denial history before anything else changes.
Excision size and margins
Excision codes step by the diameter including margins, and the note has to show the measurement. Under-measured or unmeasured lesions bill a step low.Destruction counts and premalignant versus benign
Destruction codes differ by lesion type and step by count. Miscounts or the wrong family are denials or short payments.Repairs unbilled or bundled wrong
Intermediate and complex repairs after excision are separately billable with size totaled by site group. Simple repairs are bundled. Getting this wrong loses lines or triggers recoupments.Same-day visit and procedure
The evaluation of a new problem that leads to a procedure is billable with modifier 25 when documented separately. Often it is not.Biologics without authorization
Psoriasis and eczema biologics have step therapy and per-plan criteria; doses given outside them are not paid.
What we do differently for dermatology
Specialty-matched coders and a denials specialist, working inside your own system.
We capture at the point of care
Templates that record lesion count, measured size with margins, site and method as the procedure happens, so our coder has what the code needs.Our dermatology coders bill the lines
Lesion, repair and Mohs coding by people who do it daily, with multiple-procedure and modifier rules applied and a second review on complex encounters.We reconcile pathology
Every specimen is tracked to a pathology claim, in-house or referred, so nothing is billed twice or not at all.Our biologic desk authorizes and prices
Authorization per patient per drug, expiry tracking and reimbursement checked against cost.
What we bill
The procedure and code families your account team already works in.
Dermatology billing, asked and answered.
What a physician-owner in this specialty asks on the first call.
How does VisMed make sure excisions are coded at the right size?
By capturing the measured diameter including margins in the note at the time of the procedure. VisMed’s templates prompt for it, and our coder will not bill a step the note does not support, or a step below what it does.
Can repairs be billed with excisions?
Intermediate and complex repairs, yes, with lengths summed by anatomical group and the multiple-procedure rules applied. Simple repairs are included in the excision. VisMed applies the distinction per encounter.
Does VisMed handle Mohs billing?
VisMed’s coders who work Mohs regularly handle stage and block coding, same-day repairs and flaps, and the pathology component rules.
How does VisMed keep cosmetic work out of insurance claims?
VisMed charges cosmetic services to the patient in your system under a separate workflow, and they never appear on a claim. Where a medically necessary procedure and a cosmetic one happen the same day, the documentation and charges are kept distinct.
Does VisMed bill phototherapy?
Yes. Phototherapy is billed per session with the diagnosis and treatment plan the payer requires, and most plans set frequency limits or require authorization after a number of sessions. VisMed tracks the count per patient so treatment continues inside coverage.
Also in medical specialties
Cardiology
Diagnostics, device checks and cath-lab professional fees.
Endocrinology
CGM, infusion and chronic-condition management codes.
Gastroenterology
Endoscopy, ASC splits and screening-vs-diagnostic rules.
Hepatology
Infusions, specialty drugs and prior authorization.
Nephrology
Dialysis MCP, monthly capitation and transplant follow-up.
Pulmonology
PFTs, sleep crossover and DME orders.
Rheumatology
Biologic infusions, J-codes and buy-and-bill.
Neurology
EEG/EMG, infusion and long-visit E/M.
Oncology
Chemotherapy administration, drugs and NDC reporting.
Hematology
Infusion and lab-linked visits.
Immunology & allergy
Testing panels and immunotherapy series.
Infectious disease
Inpatient rounds, long-term therapy and telehealth.
Pain management
Injections, ablations and strict authorization trails.
Psychiatry
Med-management with therapy add-ons, parity rules.
All specialties
The full list, in six groups
See where your dermatology practice is losing money. Free.
Six months of aging and denials, read by people who bill your specialty every day — quantified as monthly leakage with a recovery estimate. Yours to keep.
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