Dermatology billing for practices and groups: office visits with same-day procedures, biopsies and destructions, excisions and Mohs surgery with their repairs, and phototherapy and injections, worked inside the software you already use.
Dermatology billing services turn every visit and procedure into a paid claim. Each lesion is coded by what was done, its size and what the pathology showed, a same-day visit is billed only when it was separate, and every payment, denial and patient balance is followed until it is resolved.
$103M
in improper Medicare payments to dermatology in CMS’s 2025 review, a 3.4% improper payment rate
39.6%
of those dermatology errors were incorrect coding, and another 60.4% were missing or insufficient documentation
Dermatology claims are built lesion by lesion. A biopsy, a destruction and an excision can happen at the same visit on different spots, each with its own code, and an excision cannot be coded until the pathology report says whether the lesion was benign or malignant and the note records its size with margins. Add Mohs surgery billed by stage and tissue block, repairs coded by length and complexity, and a visit that is often on the same day, and one appointment can carry several lines that each need support.
The lesion’s size and pathology decide the claim. That is why we wait for pathology on excisions and check the measurements, sites and modifiers on every dermatology claim before it goes out, not after it is denied or downcoded.
Most dermatology practices bill office procedures, skin cancer surgery and cosmetic or uncovered services in the same week, often for the same patient.
Pays forNew and established visits, plus biopsies, destructions of premalignant lesions, injections and other procedures done at the same appointment.
Where it breaks
What we do
Pays forExcisions of benign and malignant lesions, Mohs micrographic surgery by stage, and the repairs that close the wound.
Where it breaks
What we do
Pays forRemoval of benign lesions when it is medically necessary, phototherapy, and the cosmetic services patients pay for themselves.
Where it breaks
What we do
Excision codes are chosen by two facts. The first is the excised diameter: the lesion’s largest clinical diameter plus twice the narrowest margin needed for complete removal, measured before the excision. The second is the pathology: benign lesions are coded from 11400 to 11446 and malignant ones from 11600 to 11646, by body area and size. Because the second fact comes from the lab, an excision should not be billed until the report is back.
Simple closure is included in the excision code. An intermediate or complex repair is billed separately, by the total length of the repair in centimeters within each anatomic group, and the note has to describe the layered or complex closure.
What we do: before an excision claim goes out, we check the measured size, the margins, the site and the pathology result, and code the repair from its documented length and type. If anything is missing, we ask the provider the same day, rather than guess and send a claim that is downcoded or denied.
Dermatology claims are coded lesion by lesion: what was done, how large it was and what the pathology showed. Below is each common code and what payers want documented. Commercial plans add their own authorization and bundling rules, and we check each one.
| Code | What it covers | What payers look for |
|---|---|---|
| 99202 to 99215 | Office visits (E/M) | The level matches the decision making or time documented; modifier 25 with a same-day procedure only when the visit is separate. |
| 11102 to 11107 | Skin biopsies: tangential, punch and incisional | One primary code for the most involved method used, and add-on codes for each additional lesion. |
| 170001700317004 | Destruction of premalignant lesions | 17000 for the first lesion and 17003 for lesions 2 to 14, or 17004 alone for 15 or more. |
| 1711017111 | Destruction of benign lesions, such as warts | By count: up to 14 lesions, or 15 or more. |
| 11400 to 11446 | Excision of benign lesions | Coded by site and excised diameter, after pathology confirms the lesion was benign. |
| 11600 to 11646 | Excision of malignant lesions | Coded by site and excised diameter, once pathology confirms malignancy. |
| 17311 to 17315 | Mohs micrographic surgery | By site, stage and number of tissue blocks; the surgeon acts as both surgeon and pathologist. |
| 12031 to 1205713100 to 13160 | Intermediate and complex repairs | Billed separately from the excision, by total length in centimeters and anatomic group. |
| 9691096912 | Phototherapy | The treatment type and the response documented; authorization from many plans. |
| 1190011901 | Intralesional injections | By number of lesions injected, up to seven or more than seven, with the drug billed separately. |
An office visit that is significant and separate from a same-day biopsy or destruction. Modifier 25 explained
A procedure on a different lesion or site from another procedure at the same visit. Our modifier 59 guide
Medicare: the patient signed an Advance Beneficiary Notice for a service that may not be covered.
Medicare: a service expected to be denied, with no signed Advance Beneficiary Notice.
A planned second procedure, such as a staged repair, during the global period.
A procedure on a new lesion during the global period of an earlier excision.
Sources: Medicare NCCI Policy Manual, chapter III (integumentary system); Medicare Claims Processing Manual, chapter 12 (physician services and global surgery) and chapter 30 (financial liability protections); Medicare local coverage rules for removal of benign skin lesions. CPT is a registered trademark of the American Medical Association; the descriptions above are summaries. Reviewed October 2026.
It is not for every practice. If you are a hospital-employed group whose billing the hospital handles, you do not need us. And if your in-house team keeps denials low and receivables current, keep them, and consider a periodic billing audit instead.
We look at your clean-claim rate, your denials by payer and reason, lesion coding, pathology holds, modifier 25 use, authorizations, and your aging receivables, and tell you what we find, whether or not you go further with us.
We get access to your practice management system and clearinghouse, load each payer's authorization and bundling rules and your fee schedules, list pending pathology and open authorizations, and agree how escalations work. Most practices are live within one to two weeks.
Visits and procedures are coded and claims submitted within 24 hours. Rejections are corrected the same day, remittances posted as they arrive, lesion sizes, pathology and modifiers checked, and denials worked to their cause, all inside your system.
A report you can read in ten minutes: what was billed and collected by payer, site and service line, what was denied and why, authorizations pending, and what is aging.
You do not change systems to work with Summit Billing Solutions. We work in the practice management and EHR systems below, and through the clearinghouse you already use. If your EHR is not shown, ask; the list grows as we onboard practices.
95-98%
First-pass claim rate
24 hrs
Claims submitted within
28
Average days in A/R
Dermatology practices mix medical visits, many small procedures and, for some, Mohs surgery and cosmetic work that insurance does not pay. You can pay a billing company a percentage, a flat fee or a price per claim; a percentage keeps its fee tied to what insurers actually pay.
Summit Billing Solutions charges between 3% and 9% of monthly collections. What moves the number for a dermatology practice is the mix of medical, surgical and cosmetic work, procedure volume, Mohs volume, and how clean the receivables are when we take them on, which is why we quote your exact rate after the free account review, not before.
3% to 9%
of monthly collections
We bill for more than 40 specialties, for practices in all 50 states, from Salem, New Hampshire. Each one has its own codes, modifiers and payer rules.
A free account review looks at your clean-claim rate, your denials by payer and reason, lesion coding and pathology holds, modifier 25 and authorizations, and your aging receivables, and tells you what we would change. No cost, no obligation, and no pressure to continue. What the review covers, step by step, is on the free account review page.
50A Northwestern Dr Ste 3, Salem, NH 03079-4827
603-207-3172
(866) 906-3116
info@summitbillingsolutions.com
Mon - Fri @ 9am - 5pm
