2013 Coding and Documentation Manual for Dermatology There are many manuals that offer the latest CPT information; the AMA publishes its own, as do various companies. Are you curious about what codes have been added or redefined in CPT 2013? All of the changes are listed in Appendix B of the AMA manual. The AAD offers a dermatology-specific coding manual that includes all of the dermatology-relevant CPT updates; as a bonus, it also includes guides for dermatologists to use in participating in Medicare’s various incentive and reporting programs and tips for handling audits. Lastly, one may wonder, “When is the updated CPT released every year?” The CPT updates are typically available in October of each year but its new/revised codes go into use on Jan. 1. So if you haven’t purchased a new coding manual, the time is now. You can order the Academy’s coding manual online at www.aad.org/storeorcall(866)503-SKINto order it. Interestingly, the new year’s ICD diagnostic codes are also released in October. However, the ICD codes become effective on Oct. 1. That is why when ICD-10 rolls in it willbeactivatedonOct.1,2014ratherthan Jan. 1, 2015. Peculiar, but true. (Learn more about implementing ICD-10 at www.aad.org/ ICD10.) In subsequent issues of Cracking the Code, I will endeavor to explain specific peculiarities and challenges of CPT coding. dw ICD-9-CM Express Coder LABORATORY 99000 Handling/specimen transfer MICROBIOLOGY 87070 Bacterial culture 87075 Aerobic culture 87101 Fungi, mold, yeast, skin, hair, nail 87205 Stain: Gram, Giemsa 87207 Inclusion bodies/parasites 87209 Complex Stain 87210 KOH, wet mount 87220 KOH, fungi, ova, mites CHEMICAL PEEL 15788 Facial, epidermal 15789 Dermal DEBRIDEMENT 11000 Eczema, infected skin, up to 10% 11001 Each additional 10% 11042 Subcutaneous, first 20 sq cm 11045 each add’l 20 sq cm 11720 Nails, any method 1-5 11721 Nails > 6 Nail Matrix SURGICAL PATHOLOGY 11730 Avulsion nail plate part/ complete simple; single 11732 Each additional nail plate 11750 Excise nail & matrix/part/ complt perm removal: 11752 W/amputation tuft distal phalanx MEDICINE ALLERGY 17106 Cutaneous vascular prolife rative lesion; < 10 sq cm 17107 10.0 cm to 50.0 sq cm 17108 > 50 sq cm 17110 Flat wart, molluscum contagiosum, milia; 1-14 lesions 17111 > 15 lesions 17250 Chemical cauterization, granulation tissue 46916 Anus, simple; cryosurgery 54050 Penis, simple; chemical 54055 Electrodesiccation 54056 Cryosurgery 54057 Laser surgery 54060 Surgical excision 54065 Destruction of lesion, penis, extensive 88300 Gross exam only, Level 1 88302 Gross + micro exam, Level 2 88304 Skin, cyst, tag, Level 3 88305 Skin, other, Level 4 88329 Path Consult during surgery 88331 1st tissue block w/frozen section, single spec. 88332 Each additional tissue block w/frozen section 88333 Path Consult (Touch Prep) 88346 Immunofluorescent study, each ant. body, direct 95044 Patch/application tests; # (specify number) 95052 Photopatch test # (specify number) DERMATOLOGY PROCEDURES 96900 Actinotherapy (Ultraviolet light) 96902 Microscopic examination of hair 96904 Whole body integumentary photography 96910 Photochemotherapy, tar, petroleum + UVB 96912 Psoralens & UVA (PUVA) 96913 Photochemotherapy TX, 4-8 hours with physician supervision 96920 Laser Treatment of psoriasis, < 250 sq cm 96921 250 – 500 sq cm 96922 over 500 sq cm INJECTIONS/INTRODUCTIONS G9142 Influenza A (H1N1) vaccine, any admin route 96372 Injection, IM/subq 11900 Intralesional; < 7 lesions 11901 7 lesions 11950 Subcutaneous filling mat; = < Icc 96365 Infusion Therapy < hour 96366 Infusion Therapy (each hour, up to 8) 96372 Intramuscular/Subcutaneous (IM)(SC) (specify drug) 96374 Intravenous (IV) SURGICAL SERVICES Adjacent Tissue Transfer/ Rearrangement 14000 Trunk; defect = < 10 sq cm 14020 Scalp/arm/leg = < 10 sq cm 14040 Forehead/chin/cheek/mouth/neck/ axillae genitalia/hand/foot < 10 sq cm 14060 Lid/nose/ear/lip = < 10 sq cm 14301 any area defect size 30.1-60.0 sq cm 14302 each additional 30.0 sq cm, or part thereof Chemodenervation (Hyperhydrosis) 64650 Both axillae 64653 Scalp, face, neck, per day 64999 Unlisted procedure: feet or hands BIOPSY 11100 Skin/subcutaneous tissue mucous membrane, 1 lesion 11101 Each additional, separate lesion 11755 Nail unit, any method 40490 Lip incl. only vermilion/mucosal area 54100 Penis 56605/6 Vulva or perineum 67810 Eyelid incl. lid margin, tarsal plate, or palpebral conjuctiva 69100 External ear DESTRUCTION LESION Premalignant Lesion 17000 With local anesthesia, one lesion 17003 2nd through 14th lesion 17004 15 or more lesions Benign Lesions Malignant 17260 17261 17262 17263 17264 17266 17270 17271 17272 17273 17274 17276 17280 Trunk/arm/leg < 0.5 cm 0.6 to 1.0 cm 1.1 to 2.0 cm 2.1 to 3.0 cm 3.1 to 4.0 cm > 4.0 cm Scalp/neck/hand/foot/genitalia < 0.5 cm 0.6 to 1.0 cm 1.1 to 2.0 cm 2.1 to 3.0 cm 3.1 to 4.0 cm > 4.0 cm Face, ear, eyelid, nose/lip/ mucous membrane < 0.5 cm 17281 0.6 to 1.0 cm 17282 1.0 to 2.0 cm 17283 2.1 to 3.0 cm 17284 3.1 to 4.0 cm 17286 > 4.0 cm EXCISION, LESION Benign Lesion, Including Margins 11400 11401 11402 11403 11404 11406 11420 11421 11422 11423 11424 11426 11440 Trunk/arm/leg < 0.5 cm 0.6 to 1.0 cm 1.1 to 2.0 cm 2.1 to 3.0 cm 3.1 to 4.0 cm > 4.0 cm Scalp/neck/hands/feet/genitalia < 0.5 cm 0.6 to 1.0 cm 1.1 to 2.0 cm 2.1 to 3.0 cm 3.1 to 4.0 cm > 4.0 cm Face/ear/eyelids/nose/lips/ mucous membranes < 0.5 cm 11441 0.6 to 1.0 cm 11442 1.0 to 2.0 cm 11443 2.1 to 3.0 cm 11444 3.1 to 4.0 cm 11446 > 4.0 cm Malignant Lesion, Including Margins Shaving, Lesion 11300 Trunk/arms/legs. 1 lesion; lesion = < 0.5 cm 11301 0.6 to 1.0 cm 11302 1.1 to 2.0 cm 11303 > 2.0 cm 11305 Scalp/neck/hand/ft/genit. 1 les: les = < 0.5 cm 11306 0.6 to 1.0 cm 11307 1.1 to 2.0 cm 11308 > 2.0 cm 11310 Face/ears/eyelids/nose/lips/ muc memb: lesion = < 0.5 cm 11311 0.6 to 1.0 cm 11312 1.0 cm 11600 Trunk/arms/legs: < 0.5 cm 11601 0.6 to 1.0 cm 11602 1.1 to 2.0 cm 11603 2.1 to 3.0 cm 11604 3.1 to 4.0 cm 11606 > 4.0 cm 11620 Scalp/neck/hands/feet/ genitalia: = < 0.5cm 11621 0.6 cm to 1.0 cm 11622 1.1 to 2.0 cm 11623 2.1 cm to 3.0 cm 11624 3.1 cm to 4.0 cm 11626 > 4.0 cm 11640 Face/ear/eyelids/nose/lips/ mucous membranes: < 0.5 cm 11641 0.6 to 1.0 cm 11642 1.1 to 2.0 cm 11643 2.1 to 3.0 cm 11644 3.1 to 4.0 cm 11646 > 4.0 cm Skin Graft Mohs Micrographic Surgery 17311 1st stage, head/neck/hands/feet/genitalia 17312 Additional stage 17313 1st stage, trunk/arms/legs 17314 Additional stage 17315 Each additional block, any stage Incision/Drainage Skin Tag Removal 10040 Acne surgery 10060 Abscess: simple/single 10061 Complicated/multiple 11200 Any area; = < 15 les 11201 Each additional 10 lesions Strapping Other Procedures 29580 Unnaboot application 29581 Multi-layer compression bandage application, below knee 17360 Chemical exfoliation for acne 17340 Cryotherapy for acne Paring/Cutting Venipuncture 11055 Benign hyperkeratotic lesion; 1 11056 2 to 4 11057 > 4 36416 Collection capillary blood finger/heel/ear 36415 Collection venous blood by venipuncture Repair, Complex 13100 Trunk; l.l cm to 2.5 cm 13101 2.6 cm to 7.5 cm 13102 Each additional 5 cm or less 13120 Scalp/arms/legs: 1.1 cm to 2.5 cm 13121 2.6 to 7.5 cm 13122 Each additional 5 cm or less 13131 Forehead/cheek/chin/mouth/axilla/neck/ genit/hands/foot: 1.1 cm to 2.5 cm 13132 2.6 to 7.5 cm 13133 Each additional 5 cm or less 13150 Eyelids/nose/ears/lips: < 1.0 cm 13151 1.1 to 2.5 cm 13152 2.6 to 7.5 cm 13153 Each additional 5 cm or less Repair, Intermediate 12031 Scalp/axila/trunk/extrem (exclud hands/foot); < 2.5 cm 12032 2.6 to 7.5 cm 12034 7.6 to 12.5 cm 12035 12.6 to 20.0 cm 12041 Neck/hand/foot/external genitalia; = < 2.5 cm 12042 2.6 to 7.5 cm 12044 7.6 to 12.5 cm 12045 12.6 to 20.0 cm 12051 Face/ear/eyelid/nose/lip/ mucous membrane: < 2.5 cm 12052 2.6 to 5.0 cm 12053 5.1 to 7.5 cm 12054 7.6 to 12.5 cm 12055 12.6 to 20.0 cm Sclerosing Injection 15002 Surgical prep recipient site trunk/ arms/legs 15003 Each additional 100 sq cm 15004 Surgical prep recipient site face/scalp/eyelids/mouth/neck/ears/etc 15005 Each additional 100 sq cm 15200 Full thickness, free, incl dir clos; trunk, = < 20 sq cm 15220 Scalp/arm/leg; = < 20 sq cm 15240 Forehead/cheek/chin/mouth/neck/axila/ genit/hand/ft: < 20 sq cm 15260 Nose/ear/eyelid/lip: = < 20 sq cm 15740 Flap, island pedicle 15750 Flap, neurovascular pedicle E/M SERVICES Office/New Patient 99201 Self limiting, minor 10 min 99202 Self limit-low/mod complexity 20 min 99203 Mod severity 30 min 99204 Mod severity 45 min 99205 Mod-high severity 60 min Office/Established Patient 99211 No phys supv 5 min 99212 Self-limit minor 10 min 99213 Low-mod severity 15 min 99214 Mod-high severity 25 min 99215 Mod-high severity 40 min Consult/Outpatient, New/Established Patient E/ M Pocket Pro 36468 Spider veins, single/multiple: limb/trunk 36469 Face 36470 Single vein 36471 Multi vein, same leg 99241 Self limit/minor 15 min 99242 Low severity 30 min 99243 Mod severity 40 min 99244 Mod-high severity 60 min 99245 Mod-high severity 80 min Consult/Inpatient, New/Established Patient 99251 Initial visit: minor 20 min 99252 Low severity 40 min 99253 Mod severity 55 min 99254 Mod-high severity 80 min 99255 Mod-high severity 110 min Pre-Order TODAY and Save! Supplies Injections J0585 Botulinum toxin, Type A per Unit J0702 Betamethasone acetate & sodium phos 3 mg J0704 Betamethasone sodium phos 4 mg J1100 Dexamethasone sodium phos 1 mg J9040 Bleomycin sulfate 15 units J9260 Methotrexate sodium 50 mg J3301 Triamcinolone acetonide per 10 mg J3302 Triamcinolone diacetate per 5 mg J3303 Triamcinolone hexacetonide per 5 mg J3490 Unclassified drugs Miscellaneous 99070 Supply/mat provided by phys. not incl w/visit/other serv A4550 Surgical trays A9270 Non-covered service CPT only © 2010 American Medical Association. All Rights Reserved. Keep up-to-date with the latest in coding and reimbursement. Available January 2013. Don’t wait, order yours now! To pre-order call the Member Resource Center at (866) 503-SKIN (7546). Save $20 when you mention promo code DWCODE0103. RESOURCES Copyright © 2012 American Academy of Dermatology. All rights reserved. Dermatology WorlD // January 2013 5