Coding
Documentation for Mohs Surgery
In 2013, the Centers for Medicare and Medicaid Services (CMS) issued a guidance to reduce reimbursement issues for Mohs micrographic surgery. Dr...
Although there are new telehealth codes for inpatient services and end-stage renal disease management, there are still none that are relevant to dermatology.
Place of service codes have been updated. Place of service code 19 refers to “off campus outpatient hospital” settings while place of service code 22 has been revised to “on campus outpatient hospital.” If your practice is a facility, consult the Medicare Claims Processing Manual (20.4.2) on the site of service payment differential for further enlightenment.5 Do note that CMS is increasingly interested in physicians who use wrong place of service codes.
Incident to billing rules are somewhat clearer. The physician or other practitioner who bills must be the supervising physician or practitioner. Services cannot be provided by individuals who have been excluded from Medicare, Medicaid, or other federal programs, nor can they be provided by an individual who has had Medicare enrollment revoked. State laws that are more restrictive take precedence.
Of course, the Relative Value Scale Update Committee (RUC) process moves on as always and you likely will receive 1 or more surveys in the near future. If you get one of these surveys, do not delete it. The surveys are the currency of the RUC, and if you give your RUC team bad or no data, the specialty will suffer cuts in valuation of what we do. If you have questions about the survey, contact the American Academy of Dermatology staff as listed in the survey. If you want to learn more about RUC, visit the American Medical Association website.6 To see the current relative value units for what dermatologists do and the typical time for these procedures, visit the CMS website, which provides resources that supply tremendous amounts of data on code valuation including documents detailing relative value units for every CPT code.7 You also can access current time values for preservice work, intraservice work, and postservice work times for all CPT codes in the entire CPT Professional Edition. They are based on typical times and are the major determinants of what you get paid. Happy reading.