Modifier 25 on procedure days
When a significant, separately identifiable evaluation happens on the same day as a procedure, it is separately payable — but only with correct modifier use and documentation. This is heavily scrutinized.
Specialties › Dermatology
Dermatology Medical Billing Services
Dermatology is procedure-dense: a single visit can include an evaluation, several biopsies, destruction of multiple lesions and a specimen sent to pathology. Revenue depends on reporting those services in the right combination — lesion counts, sizes, sites, and whether the visit itself was separately significant. It is also the specialty where the line between medical and cosmetic is policed most closely.
What makes it hard
Dermatology billing challenges we solve
These are the issues that repeat every month in dermatology practices — and the ones we fix at the source rather than reworking claim by claim.
Lesion counts, sizes and sites
Excisions and destructions are billed by number, measured size and anatomic location. Documentation that omits measurements systematically underpays the practice.
Cosmetic vs medically necessary
Payers deny services they consider cosmetic. Medically necessary treatment that resembles cosmetic care must be documented to show why it was warranted.
Mohs and staged surgery
Mohs micrographic surgery is billed by stage and block count with its own reporting rules, and repair or reconstruction may be separately reportable.
Pathology and specimen handling
Whether pathology is billed in-house or referred changes what the practice may report — a frequent source of both lost revenue and compliance risk.
Coding depth
Common code families we work with
- 11102–11107 — tangential, punch and incisional biopsies with add-ons
- 17000 / 17003 / 17004 — destruction of premalignant lesions, by count
- 17110 / 17111 — destruction of benign lesions
- 11400–11646 — excision of benign and malignant lesions by site and size
- 17311–17315 — Mohs micrographic surgery by stage and block
- 88304 / 88305 — surgical pathology examination
- 99202–99215 with modifier 25 — separately identifiable office visit
Listed for context only — this is not billing advice, and payer policy varies. Our certified coders work to AAPC and AHIMA standards.
Denial prevention
Top denial drivers in dermatology
- Office visit denied as included in the same-day procedure
- Lesion size or count not documented
- Service considered cosmetic and not medically necessary
- Biopsy add-on codes reported incorrectly
- Pathology billed by a party not entitled to report it
We root-cause denials by payer and procedure, then fix the upstream workflow so the same denial stops recurring.
Why ERG
What you get with ERG
Specialty-trained billers
Your account is worked by people who bill dermatology every day — not a general pool learning your rules on your claims.
95%+ net collection rate
Relentless follow-up on every claim, with aged A/R worked rather than written off.
No long-term contract
Performance-based pricing — a percentage of what we collect. Stay because the results are good, not because you are locked in.
5–10 day onboarding
We run parallel with your current process until the transition is verifiably clean.
Human-led, AI-supported
Our certified coders work every claim; AI tools help them catch more before submission.
HIPAA-compliant throughout
Strict PHI controls, access limits and staff training across the whole workflow.
FAQ
Dermatology billing — common questions
Do you bill Mohs surgery?
Yes. We bill Mohs by stage and block count along with any separately reportable repair, which is one of the higher-value and most frequently mis-reported areas of dermatology revenue.
How do you handle cosmetic versus medical claims?
We bill medically necessary services to insurance with documentation that supports necessity, and keep genuinely cosmetic services on a self-pay track — so covered care is not written off and non-covered care is not billed to the payer in error.
Is modifier 25 risky to use?
It is legitimate when a separately identifiable evaluation truly occurred and is documented. The risk comes from routine, undocumented use. We bill it where the record supports it, which protects both revenue and compliance.
Can you handle a high-volume dermatology practice?
Yes. Dermatology's mix of high visit volume and multiple procedures per visit is exactly the workload our specialty-trained billers and QA process are built for.
Client results
What practices say about working with us
★★★★★The weekly reporting is the difference. I see exactly where money is stuck instead of guessing at month-end.
— Robert W., Practice Owner
★★★★★Our A/R days dropped from 58 to 31 in one quarter. First time in years I actually trust my numbers.
— Sarah M., Practice Manager
Next step
See what your dermatology practice is leaving uncollected
A no-obligation A/R analysis. We review your aging, denial patterns and coding mix, then show you exactly where the recoverable revenue is.
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