Most Dermatology practices and dermatology billing companies have already succumbed to the fact that reimbursements rely heavily on correctly applying modifiers. A deep understanding of all the components and documentation as well as actual requirements in codes has now become a nationwide standard. Correct modifiers and the use of code sets to compliment them is only half the battle in Dermatology billing.
Dermatology billing doesn’t require as many certifications as other types of billing however if ones practice wants to stay far away from audits, it does require attention to detail. The foundation of dermatology billing is in the medical record itself. Certified and credentialed coders abstract the contents of the patient’s record and then use set standards and rules to bill out the contents of the service rendered. Now when that modifier is not correct the claim is then denied or rejected. Dermatology procedures are described by Common Procedure Terminology (CPT) codes. Now many of these codes are then compounded or modified based on the practice and service for instance Skin graft procedures are determined by size and by the graft material used. The medical documentation and or record must specifically document the graft material and the size and the clinical notations of all and any other relevant data. If any information is missing from the medical record, a clean claim cannot be submitted for procedures performed if any of the codes do not match the records the claim can be denied etc etc.
Additionally, the CPT codes submitted in the claim match the actual detail of the patient record, dermatology specialist and or dermatology billing companies know the requirements established by insurance providers to ensure payment and to ensure that it was paid promptly. Guidelines are created to assist in code selection, but many payers require some code sets to be combined with others when two procedures are performed during the same patient encounter these are how modifiers are relevant. The Medicare program standardizes the National Correct Coding Initiative (NCCI) and stipulates which codes must be bundled.
Professional Dermatology Billing Providers
Dermatology practices that look to team up with Infallible typically see their claims reimbursed without problems and typically in a rapid response and without denials. If a payer performs an audit, as CMS routinely does through its RAC program, practices using Infallibill won’t suffer from insurance clawbacks or penalties. Clean claims ensure business efficiency and growth. How is this possible: Years of studing data and only working with groups that are trying to do the right thing we are here to help let Infallibill guide you to a profitable 2018