Dermatology Billing That Gets Mohs Right
Mohs staging codes, destruction specificity, biopsy bundling rules, cosmetic vs. reconstructive documentation — our dermatology billing team handles the nuance that drives a 31% average revenue increase on Mohs alone.
97.4%
Clean Claim Rate
3.6%
Average Denial Rate
19 Days
Average AR Days
+31%
Average Mohs Revenue Increase
BILLING CHALLENGES WE SOLVE
Dermatology's Hidden Revenue Leaks
These are the six billing issues that cost dermatology practices the most — and what we do about each one.
Mohs Surgery Staging
Mohs codes (17311–17315) require precise staging documentation including number of stages, number of blocks, tissue mapping, and specimen count. Errors in any element trigger immediate denial or downcoding.
Cosmetic vs. Reconstructive
The distinction between cosmetic (non-covered) and reconstructive (covered) procedures hinges entirely on documentation. Insufficient medical necessity language leads to automatic denials — even for procedures that should be covered.
Destruction Code Specificity
Destruction codes (17000–17286) require specificity by lesion type (benign, premalignant, malignant), size, and count. Submitting a generic destruction code instead of the correct type-specific code means routine underpayment.
Biopsy Bundling
Biopsy codes (11100, 11101) are frequently bundled into excision codes when they should be separately billable. The key is procedure timing and independent documentation — our coders catch every separable biopsy.
Pathology Coordination
When dermatologists perform in-office pathology, billing must clearly delineate the surgical and pathology components. Split billing between the treating physician and pathologist requires careful coordination to avoid duplicate submission flags.
Excision Size Accuracy
Excision codes are size-dependent — millimeter errors in documented lesion or excision margin size shift the code. We verify operative documentation against submitted codes before every claim.
How Aethera Handles Dermatology Billing
Dermatology has a level of coding specificity that trips up generalist billing teams constantly. Mohs staging add-ons, lesion-type destruction codes, excision size thresholds — every element matters, and errors compound across hundreds of claims per month.
Our dermatology billing team includes Mohs-specialist coders who review tissue maps, operative reports, and pathology documentation before each claim is submitted. Every dermatology client gets a payer-specific rules library maintained quarterly.
Our dermatology billing covers:
Mohs surgery (17311–17315) with block and stage tracking
Benign, premalignant, and malignant destruction codes
Excision coding by size, location, and lesion type
Biopsy (11100, 11101) — separable vs. bundled analysis
Cosmetic vs. reconstructive documentation support
In-office pathology (88302–88309)
Cryotherapy, laser, and phototherapy codes
Acne surgery and comedone extraction
Patch testing (95044–95052) billing
Chemical peel and dermabrasion documentation
Modifier 25 management for same-day E&M + procedure
Pathology coordination with external labs
PROCEDURE CODES
Common Dermatology CPT Codes We Bill
Dermatology-specific codes our team handles daily — each requires specialty knowledge to bill correctly.
| CPT Code | Description |
|---|---|
| 17311 | Mohs surgery, first stage, up to 5 tissue blocks |
| 17312 | Mohs surgery, each additional stage (up to 5 blocks) |
| 17313 | Mohs surgery, first stage, more than 5 tissue blocks |
| 17314 | Mohs surgery, each additional stage (more than 5 blocks) |
| 17000 | Destruction of premalignant lesion, first lesion |
| 17003 | Destruction of premalignant lesions, 2nd–14th lesion |
| 17110 | Destruction of benign lesions, up to 14 |
| 11100 | Biopsy of skin, first lesion |
| 11101 | Biopsy of skin, each additional lesion |
| 11400 | Excision, benign lesion, trunk/arms/legs, 0.5 cm or less |
| 11440 | Excision, benign lesion, face/ears/nose, 0.5 cm or less |
| 99214 | Office visit, established, moderate medical decision making |
Dermatology Practice
High Mohs volume with years of miscoding. Reconstructive cases written off for insufficient documentation. Denial rate at 18%.
Denial Rate
18%
4.3%
Mohs Revenue
Baseline
+31%
Reconstructive Claims
Written off
+$9,800/mo
AR Days
39
19
FAQ
Dermatology Billing Questions
Common questions from dermatologists and practice managers.
Do you have coders who specialize specifically in Mohs surgery billing?
Yes. We assign Mohs-specialist coders to dermatology accounts with significant Mohs volume. These coders review operative reports against Mohs tissue maps, verify block counts, and apply the correct staging codes for every case.
How do you handle the cosmetic vs. reconstructive documentation issue?
We work with practices to develop payer-specific documentation templates that satisfy medical necessity language requirements for each major carrier. When a claim is at risk of cosmetic denial, we flag it for provider documentation review before submission.
We perform biopsies and excisions in the same visit. How do you handle that?
We evaluate each case on its own merits. When a biopsy is independently documented and the excision is performed at a separate site or session, we bill them separately with appropriate modifiers. When bundling rules apply, we apply them correctly — neither overbilling nor underbilling.
Do you handle in-office pathology billing?
Yes. We manage in-office pathology billing including tissue processing and examination codes (88302–88309). We coordinate professional and technical component billing and ensure no duplicate submission with external pathology labs.
How quickly can you improve our Mohs billing accuracy?
In our experience, Mohs billing corrections take effect within the first 30 days of service. Our onboarding process includes a dedicated Mohs coding review during weeks 1–2 before the first claim submissions go out.
Ready to Get Your Mohs Billing Right?
Start with a free dermatology billing assessment. We'll audit your Mohs coding, destruction specificity, and denial patterns.
Get Free Derm Assessment