Dermatology CPT Codes 2026: Codes, Modifiers, and the Rules That Decide Payment

Dermatology CPT codes are the five-digit procedure codes that report skin biopsies, lesion destruction, excisions, Mohs surgery, wound repairs, pathology, phototherapy, and office visits to insurance payers. Eight families cover almost every dermatology billing code a practice submits: E/M visits 99202-99215, biopsies 11102-11107, destruction 17000-17004 and 17110-17111, excisions 11400-11646, Mohs surgery 17311-17315, repairs 12001-13160, pathology 88304-88341, and phototherapy 96900-96913 plus 96567.

Four variables drive code selection in this specialty: technique, lesion count, excised diameter, and anatomic site. Each governs a different code family. Diagnosis governs none of them.

Practices lose money at every one of those four. Document lesion size on a biopsy and you have recorded the wrong measurement, because biopsy codes run on technique. Bill 17000 five times for five actinic keratoses and you have stacked a base code that should have been one base plus four add-ons.

This guide covers the dermatology CPT codes your practice bills most, plus the rules that decide whether they pay: NCCI bundling edits, add-on logic, modifier placement, and measurement timing. We checked every code here against the AMA CPT 2026 code set and the CMS NCCI Policy Manual. Codes that circulate incorrectly on other lists appear in Section 16.

Key Takeaways

• Biopsy codes run on technique, not diagnosis. 11102 is tangential, 11104 is punch, 11106 is incisional, and each carries a matching add-on code for additional lesions.
• Destruction codes run on lesion count. 17000 covers the first premalignant lesion, +17003 covers lesions 2 through 14, and 17004 stands alone at 15 or more.
• Excision codes run on size measured before anesthesia, and the measurement includes the lesion plus the narrowest surgical margin on each side.
• NCCI bundles a biopsy into the removal when both happen on the same lesion at the same encounter.
• HHS-OIG found that about 61.5% of paid Medicare dermatology E/M claims carried a same-day minor procedure, and estimated $62,915,655 in overpayments where documentation failed to support modifier 25.
• CMS has proposed paying the lesser service at 50% for CY2027 when an E/M visit and a same-day global procedure appear on one claim, and named dermatology among the specialties hit hardest.

What Changed in Dermatology CPT Coding for 2026?

The AMA's CPT 2026 code set carries 418 total changes: 288 new codes, 84 deletions, and 46 revisions, all effective January 1, 2026, per the AMA CPT 2026 release. Most of that volume lands outside dermatology. Two changes land on it.

The one integumentary revision that touches dermatology

CPT 10040 changed for 2026. Its descriptor moved from "acne surgery" to "extraction," and it stands as the only revision in the Integumentary System section of the 2026 code set.

Your claims will not stop paying because of it. Your next audit is the problem. A reviewer comparing the operative note against the code descriptor finds two things that do not line up, and that becomes a documentation finding. Update the superbill line, the EHR favorites list, and the charge description master before the quarter closes.

Annual code set maintenance runs the same way for diagnosis codes, and the same discipline applies to ICD-10 transition planning.

New surface radiation therapy codes for skin cancer

CPT 77436 through 77439 replaced the older superficial radiation therapy reporting structure for 2026.

Table: Surface radiation therapy CPT codes for 2026

One rule catches practices. Code 77439 reports once per course of treatment, not once per fraction. Bill it at every visit and the units fail.

Coverage sits with your MAC rather than with the code. Read the CMS superficial radiation therapy article and your local policy before the first SRT claim goes out.

What did not change, and why that matters more

The code numbers your dermatologists use every day held steady this year. Enforcement moved instead, and the dermatology coding guidelines governing same-day billing got sharper. CMS refreshes NCCI edits every quarter, closed an OIG recommendation in June 2026 directing MACs to educate dermatologists on modifier 25, and has proposed cutting same-day E/M payment starting CY2027. Section 12 covers all three.

One step before you read further: pull your 20 highest-volume codes and reprice them against the current Medicare Physician Fee Schedule. The conversion factor headline and the code-level rate move on separate tracks, and only the second one reaches your deposits.

How Are Dermatology CPT Codes Organized?

Dermatology CPT codes fall into eight families, and each family runs on a different variable.

All eight sit across three CPT sections: Evaluation and Management, the Integumentary System CPT codes numbered 10000 through 19999, and Medicine.

Table: Dermatology CPT code families and what drives code selection

Watch what happens when a coder carries one family's logic into the next. Someone trained on excisions records lesion diameter for a punch biopsy, so the note now holds a measurement the code never asked for and omits the technique it did. Someone trained on biopsies bills five destruction base codes for five actinic keratoses instead of one base and four add-ons.

Same root cause both times. Any dermatology CPT codes list that gives you the numbers without this third column leaves you guessing which rule applies.

What Are the CPT Codes for a Skin Biopsy?

Skin biopsies use three base codes selected by technique: 11102 for tangential or shave biopsy, 11104 for punch biopsy, and 11106 for incisional biopsy. Each base code carries a matching add-on code for additional lesions sampled in the same session.

Table: Skin biopsy CPT codes by technique

Lesion size never enters this decision. Neither does the suspected diagnosis. The instrument in your dermatologist's hand picks the code.

How to code two biopsy techniques in one session

Report only one primary code from the 11102 to 11107 range per encounter, no matter how many techniques the provider used. Additional lesions sampled by a different technique go to the add-on code matching that technique.

A worked example. Your dermatologist punches one lesion on the back and shaves a second on the forearm. The claim reports 11104 as the primary code and +11103 for the tangential biopsy of the additional lesion. Two primary codes on that claim would be wrong.

When a biopsy stops being separately billable

Lesion removal codes already include tissue procurement from the same lesion. Under the Medicare NCCI Policy Manual, codes 11102 through 11107 are not separately reportable where the biopsy and the removal happen on the same lesion at the same encounter. Biopsy a different lesion than the one you removed and both codes can stand.

That distinction lives in the note rather than the claim. Give each lesion its own identifier: anatomic site plus a short clinical description. A reviewer asking whether these were two lesions or one needs the chart to answer without your biller on the phone, and these are the cases that surface as CO-97 bundling denials.

Site-specific biopsy codes outside the 1110x range

Four biopsy codes sit outside the main range and get missed on superbills: 40490 for the lip, 69100 for the external ear, 11755 for the nail unit, and 67810 for the eyelid margin.

One closing rule on this family. Biopsy codes include simple closure. Adding a repair code after a biopsy creates a bundling denial you will spend an hour appealing.

Bundled biopsy claims almost never trace back to the code. They trace back to lesion identifiers in the note. MedSole reviews dermatology coding as part of full-service billing at 2.99% of collections, and that rate covers coding review, denial management, and AR follow-up together. Dermatology coding review

What Are the CPT Codes for Lesion Destruction and Cryotherapy?

Destruction codes are the dermatology CPT codes practices misbill most. They run on lesion type first and lesion count second. Codes 17000 through 17004 cover premalignant lesions. Codes 17110 and 17111 cover benign lesions.

Table: Destruction CPT codes for premalignant and benign lesions

The destruction error that repeats until someone fixes the template

Five actinic keratoses treated with cryotherapy report 17000 once and +17003 four times. Billing 17000 five times denies on the spot.

The 15-lesion threshold changes the structure rather than adding to it. Code 17004 replaces the base plus add-on combination outright, so it never appears alongside 17000 or +17003 on the same claim.

Benign lesions behave differently again. Both 17110 and 17111 pay flat inside their band, so a patient with four warts and a patient with 13 report the same code. Document the count anyway, because the superbill lesion capture field is what a reviewer checks first.

Why 17000 and 17110 are not interchangeable

Code 17000 applies to premalignant lesions only. Warts, seborrheic keratoses, and molluscum contagiosum are benign, and they belong to 17110 or 17111.

Several published dermatology code lists get this backward. A claim built from one of those lists fails on medical necessity, because the diagnosis you attach will not support the code you billed. Pair B07.9 for a viral wart with 17000 and you have handed the payer a premalignant destruction code with a benign diagnosis.

Treating premalignant and benign lesions at the same visit adds a step. Append modifier 59 or XS to the second destruction code so the NCCI edit clears.

Malignant lesion destruction

Malignant destruction splits by anatomic site first, then by size inside each site group. Trunk, arms, and legs use 17260-17266. Scalp, neck, hands, feet, and genitalia use 17270-17276. Face, ears, eyelids, nose, and lips use 17280-17286.

Practices lose money here by billing the first code in the range for every lesion regardless of diameter. That undercodes the claim, and because it still pays, nobody catches it.

Skin tag removal

Code 11200 covers up to 15 skin tags. Add-on +11201 covers each additional group of 10.

Take 22 skin tags removed in one session. The claim reports 11200 for the first 15 and +11201 once for the remaining seven. Write the count into the note, because the units on this claim are the first thing a reviewer verifies.

How Are Lesion Excision CPT Codes Selected?

Excision codes turn on three variables in order: benign or malignant pathology, anatomic site, and excised diameter measured before anesthesia.

Table: Excision CPT code ranges by pathology and anatomic site

Inside each range, the codes step up by size: 0.5 cm or less, 0.6 to 1.0 cm, 1.1 to 2.0 cm, 2.1 to 3.0 cm, 3.1 to 4.0 cm, and above 4.0 cm.

The margin rule that costs practices the most

Excised diameter equals the lesion diameter plus the narrowest margin taken on each side.

Run the arithmetic on a real case. A 1.2 cm basal cell carcinoma with 0.4 cm margins on each side gives you a 2.0 cm excision, and that lands two size tiers above the 1.2 cm most operative notes record.

Timing matters as much as the math. Measure before the local anesthetic goes in, because injection distorts the tissue and the number changes. Write the pre-anesthesia measurement into the operative note.

Miss that step and the claim codes to a lower tier every single time. It also pays every single time, which is why undercoding survives inside a practice for years while denials collect all the attention.

One removal code per lesion

CPT recognizes several ways to remove a lesion, including destruction, shave removal, and excision. The NCCI integumentary chapter allows only one removal code per lesion.

Your dermatologist may have shaved a lesion and then excised the base. Both happened. Only one gets billed.

Shave removal is not excision

Shave removal uses 11300-11313, selected by anatomic site and lesion diameter. It forms a separate family from both biopsy and excision.

Pathology coming back malignant does not convert a shave removal into an excision code. Among all the dermatology CPT codes on a claim, removal codes follow the procedure the surgeon performed, and the diagnosis follows the specimen.

Undercoded margins never trigger a denial, so most practices find them during an audit instead of on a report. Pull 30 excision notes from last quarter and read the documented measurements against the codes that went out. A week of that answers the question. Specialty billing support

What Are the CPT Codes for Mohs Surgery?

Mohs micrographic surgery reports 17311 or 17313 as the first-stage code depending on anatomic site, with add-on codes for each additional stage and for tissue blocks beyond five.

Table: Mohs micrographic surgery CPT codes

Two definitions decide whether these codes hold up. A stage is one complete cycle: tissue removal, mapping, processing, and microscopic examination. A tissue block is each individual piece of tissue examined inside that stage. Coders who blur the two report stages as blocks, and the units stop matching the operative note. Mohs surgery billing support starts with getting those two counts documented separately.

The surgeon has to be the pathologist

Mohs codes require the same physician to perform the surgery and read the histology. Send the tissue to a separate pathologist who submits their own claim, and 17311 through 17315 are no longer reportable. The case drops back to an excision code.

Confirm this before the claim leaves, not after the denial arrives.

What Mohs already pays for

NCCI treats a long list of services as included in the Mohs codes: skin biopsy and excision services in the 11102-11107, 11600-11646, and 17260-17286 ranges, plus pathology services in the 88300-88309 and 88329-88332 ranges, per the NCCI Mohs bundling rules. Reporting any of those alongside Mohs on the same lesion is incorrect coding.

One exception matters and almost nobody publishes it. A suspected skin cancer biopsied for diagnosis before the practice proceeds to Mohs can be reported separately, along with the frozen section pathology. Append modifier 59, XS, XU, or 58 to separate the diagnostic service from the definitive surgery.

Many commercial payers require prior authorization for Mohs on specific anatomic sites. A clean Mohs claim with no approval on file still does not pay, which is why prior authorization management belongs upstream of the coding conversation.

Repairs are billed separately

Repairs, grafts, and flaps stay separately reportable alongside Mohs codes. The next section covers how to select them.

A Mohs day produces one operative note and four or five separate code families. If your stages, blocks, and reconstruction are all coming off a single charge entry, some of that work is not reaching the claim.

When Is Wound Repair Billed Separately From Excision?

Lesion removal codes include simple repair, so it is not separately billable. Intermediate and complex repairs can be reported separately where the documentation supports the added complexity.

Table: Wound repair CPT codes by complexity

The length rule most teams apply backward

Add together the lengths of every repair performed in the same complexity tier and the same anatomic grouping, then report one code for the combined length. Billing each incision on its own line splits the total and drops you into lower-paying codes. Reporting a repair alongside an excision can also call for modifier 59 distinct service.

The exception that contradicts common advice

Certain small benign excision codes carry their repair inside them. NCCI 2026 Chapter 1 specifies that named benign excision codes with an excised diameter of 0.5 cm or less include simple, intermediate, and complex repair, so no separate repair code belongs on those claims.

Blanket guidance telling practices to always bill repair separately after excision generates denials on this group. Check the excised diameter before you add the repair line.

Documentation decides the tier

The gap here is wording, and it costs more than any of the dermatology CPT codes in the table above suggest.

An operative note that says the wound was closed and stops there codes as simple repair. Nobody misread anything. The note never named the layered closure your surgeon performed, so the coder had nothing to code from.

Ask your dermatologists for one sentence: the closure technique and the total length in centimeters.

Which Pathology CPT Codes Apply to Dermatology?

Dermatopathology reports through surgical pathology codes selected by specimen level, and 88305 covers most dermatology specimens.

Table: Dermatopathology CPT codes

Note the order of those last two, because published lists reverse them often. Code 88342 reports the initial antibody stain and 88341 reports each additional one.

One specimen means one pathology code

Submit multiple lesions in a single specimen container and one pathology code applies to the examination of all of them, even where the lab processes them separately. Submit them as separate specimens with precise locations recorded and separate pathology codes become reportable.

Your specimen labeling protocol decides your pathology revenue. That is a front-office workflow decision.

Slide review during a visit is not a pathology consult

A dermatologist reviewing slides from a previously removed lesion during an office visit, deciding whether more surgery is needed, is performing part of the E/M service. Consultation codes 88321 through 88325 do not belong on that claim.

What Are the CPT Codes for Phototherapy and Photodynamic Therapy?

Phototherapy reports by treatment modality, not by lesion count or body area. Code 96900 covers actinotherapy, and 96910 through 96913 cover photochemotherapy.

Table: Phototherapy and photodynamic therapy CPT codes

Three descriptor errors worth checking your list for

Laser codes 96920 through 96922 step by treated surface area in square centimeters. Any code list that assigns lesion-count tiers to these three has invented a rule CPT never wrote.

Code 96912 is PUVA, and psoralen is the photosensitizing agent. It does not report narrowband UVB delivered without a photosensitizer.

Aminolevulinic acid reports under J7308, a HCPCS Level II supply code. CPT 17308 does not exist, and it appears on more than one published dermatology list.

Authorization decides these claims, not coding

The coding on phototherapy stays straightforward. Denials come from somewhere else.

Biologics and photodynamic therapy sit behind prior authorization at most payers, and many require documented failure of topical or systemic therapy first. A correctly built claim with no approval on file is still an unpaid claim, and the appeal window runs while your team hunts for a coding error that was never there. Biologic authorization support belongs in the scheduling workflow, ahead of the visit.

Can You Bill an Office Visit and a Procedure on the Same Day?

Yes, when the visit is significant and separately identifiable from the procedure. Modifier 25 goes on the E/M code, never on the procedure code.

What Medicare says about same-day E/M

Under Medicare global surgery rules, an E/M service furnished on the same date as a minor surgical procedure carrying a 0-day or 10-day global period is included in the payment for that procedure. The decision to perform the minor procedure is part of the procedure payment on its own. Separate payment applies only where a significant, separately identifiable E/M service unrelated to that decision took place.

One clause in the NCCI 2026 modifier 25 rule catches dermatology practices more than any other. A patient being new to your practice is not sufficient on its own to justify reporting an E/M service on the same date as a minor surgical procedure. Plenty of denials trace straight back to that assumption, which is worth reviewing alongside your new patient visit coding.

The reverse assumption costs money too. The E/M service and the minor procedure do not require different diagnoses. Practices that skip the E/M because the diagnosis matches are writing off work they performed and documented, and most of that volume sits in the CPT 99213 documentation guide range.

What HHS-OIG found in dermatology

HHS-OIG reviewed Medicare dermatology E/M claims from 2019 and 2020 and reported that about 61.5% of paid E/M claims included a same-day minor surgical procedure by the same dermatologist, according to the HHS-OIG dermatology audit. In a 100-claim sample, 90 met Medicare requirements and 10 did not.

OIG estimated $62,915,655 in overpayments across the period reviewed in its full audit report.

Read the 90 before you read the 10. Nine out of 10 sampled claims held up, which tells you this billing pattern is legitimate and routine. Your exposure sits in documentation quality on a small slice of visits, not in the practice of billing an E/M alongside a procedure.

CMS acted, and has proposed going further

OIG recommended that CMS work with MACs to educate dermatologists on modifier 25 documentation. CMS closed that recommendation as implemented on June 18, 2026.

A larger change sits in front of the specialty now, and it is a proposal rather than policy. For CY2027, CMS has proposed reducing payment where a separately identifiable office or outpatient E/M visit is furnished by the same physician on the same day as a 0-day, 10-day, or 90-day global procedure. Under the CMS CY2027 proposed rule, the most expensive service pays at 100% and every other service that day pays at 50%. CMS named dermatology among the specialties facing the largest negative impact.

Nothing about that is final. Model what it would do to a month of your claims, and leave your billing behavior alone until CMS publishes a final rule.

What the note has to show

The billing is rarely the problem on these claims. The note is.

Documentation that reads as one continuous encounter gives a reviewer no way to separate the two services, and gives your appeal nothing to stand on. The note has to show work above and beyond the pre-service and post-service work built into the procedure.

Picture the visit that generates this. A patient comes in for cryotherapy on a known actinic keratosis, and while she is in the chair she mentions a new spot on her shoulder. Your dermatologist examines it, works through the differential, and decides on a plan. That evaluation has nothing to do with freezing the AK. It is separate, billable work, and the chart needs to read that way.

Ninety percent compliance across a specialty tells you the pattern is sound and the documentation carries the risk. Pull a monthly sample of same-day E/M and procedure claims, then read each one against the note rather than the claim. MedSole builds that review into denial management inside full-service billing at 2.99% of collections. Modifier 25 denial recovery

Which NCCI Bundling Rules Apply to Dermatology?

NCCI edits decide which dermatology CPT codes can appear together on one claim, and five rules account for most integumentary bundling denials.

Table: NCCI bundling rules for dermatology procedures

The edit files change every quarter

CMS publishes procedure-to-procedure edits and medically unlikely edits on a quarterly cycle, posting each quarter's CMS NCCI edit files about a month ahead of the effective date, alongside the Medicare add-on code edits that govern add-on pairings.

Denials that spike in the first two weeks of a quarter deserve a different investigation than denials building over months. Check which edit file version your clearinghouse and practice management system loaded before you retrain a single coder. A configuration gap looks like a coding gap on a denial report, and one of them takes ten minutes to fix. Our breakdown of clearinghouse edit updates covers how often each vendor refreshes.

Not every MUE value is public

CMS publishes most medically unlikely edit values and designates some as confidential, which means those never get released.

A unit-of-service denial with no published threshold to check against is not automatically an error on your side. Appeal it by documenting medical necessity for the units you billed. Citing a threshold you cannot see gets you nowhere.

Which Modifiers Are Used Most in Dermatology Billing?

Modifier 25 leads dermatology because a visit and a procedure land on the same day so often, followed by modifier 59 and the X-subset modifiers for distinct procedural services.

Table: Dermatology modifier reference

The third column is where most modifier denials originate. Modifier 25 placed on the procedure line instead of the E/M line denies the same way a missing modifier does, and the postoperative rules behind rows 24 and 79 sit in our modifier 24 postoperative rules guide.

Modifier 57 has no place in dermatology

Modifier 57 applies to an E/M service that produces the decision for a major surgical procedure carrying a 90-day global period.

Dermatology minor procedures carry 0-day or 10-day globals. The correct modifier for a same-day E/M in this specialty is 25. At least one dermatology billing guide with real reach recommends 57 anyway.

X-subset modifiers are replacing blanket 59

Payers reject unspecified modifier 59 more often now where a specific X-subset modifier fits the situation. XS carries most of the dermatology volume, because a separate lesion is a separate structure.

Which ICD-10 Codes Pair With Dermatology CPT Codes?

Every dermatology CPT code needs a paired ICD-10 code that establishes medical necessity, and a mismatch between procedure and diagnosis ranks among the fastest denial triggers in the specialty.

Table: Diagnosis codes that gate common dermatology procedures

The mismatch that fails without review

Pair a malignant excision code with a benign diagnosis, or the reverse, and the claim denies before a human ever looks at it. These surface on remittances as CO-50 medical necessity denials.

Most of these start the same way. The claim goes out before pathology returns, the report comes back changing the picture, and nobody circles back to the code already submitted. Build the cross-check into your workflow: the day the path report lands, compare the final diagnosis against what your biller sent.

L57.0 is premalignant, not malignant

Actinic keratosis codes under skin disorders caused by chronic non-ionizing radiation exposure. Documentation showing progression to squamous cell carcinoma moves the diagnosis into the C44 category, and the procedure code family moves with it.

Dermatology CPT Codes That Circulate Incorrectly

Several dermatology CPT codes circulating on published lists either do not exist or describe a different procedure. Bill from one of those lists and you get a denial that looks like a coding error, because that is what it is.

Table: Codes that appear incorrectly on dermatology code lists

How to verify a code before it goes on a claim

Three checks, and a code has to clear all three.

Confirm the descriptor in the current AMA CPT code set. Confirm the payment status and global period in the Medicare Physician Fee Schedule. Confirm the pairing against the current quarter's NCCI edit file.

Fail any one of them and the code stays off the claim.

We ran every code in this guide through that process against the AMA CPT 2026 code set and the CMS NCCI Policy Manual. The verification date sits at the top of this page.

What Is the CPT Code for a Dermatology Skin Check?

No dedicated CPT code exists for a routine or full body skin check. Skin examinations report through standard office visit E/M codes selected by medical decision-making or total time.

Which E/M code applies

New patient visits report 99202 through 99205. Established patient visits report 99212 through 99215, and most thorough skin examinations land on 99213 or 99214.

Medical decision-making or total time on the date of the encounter sets the level. The number of body areas your dermatologist examined does not.

Why preventive medicine codes do not fit

Preventive medicine codes 99381 through 99397 belong to primary care in most payer policies and seldom suit a dermatologist. Check the specific policy before you use one.

The diagnosis code decides coverage

Z12.83 is the screening diagnosis behind most skin cancer screening CPT code questions, and coverage for it varies by plan.

A patient with a suspicious lesion, a personal history of skin cancer, or another documented concern is not a screening visit. That is a medically necessary evaluation, and the diagnosis you attach should say so.

Procedures during the check bill separately

A biopsy taken during a full body skin exam reports separately under 11102 through 11107. The modifier 25 rules covered earlier govern the E/M line on that claim.

Can Dermatologists Bill G2211?

Yes. Dermatologists can bill the Medicare add-on code G2211 where the visit forms part of an ongoing, longitudinal relationship managing a serious or complex skin condition.

When it applies

G2211 attaches to office and outpatient E/M codes 99202 through 99215. It exists for the clinician serving as the continuing focal point of care for a single serious condition or a complex condition.

In dermatology that describes severe psoriasis, moderate to severe atopic dermatitis, and complex chronic wound management. Your practice carries ongoing responsibility for the condition rather than resolving a discrete problem and closing the chart.

The restriction that catches dermatology practices

G2211 is not payable on a date where the E/M service requires modifier 25 for a minor procedure.

That combination describes a large share of dermatology visits. Append both and the add-on gets rejected while the E/M pays, which makes the pattern hard to spot on a remittance.

It is a Medicare code

CMS created G2211 as a HCPCS code. Commercial recognition varies, so verify the policy per plan before you build it into a charge template.

What the note has to show

The chart has to reflect the longitudinal responsibility, not the single encounter. A note documenting only what happened that day will not support the add-on in an audit.

What Dermatology Coding Errors Cost, and What a Billing Partner Should Fix

Where dermatology practices lose money

Four failure points account for most of it. Every one starts in the documentation rather than in the dermatology CPT codes themselves, which is the part practices get wrong when they go shopping for a billing partner.

• Undercoded excision margins. These never deny, so nobody catches them. You find them by sampling notes against submitted claims, and only if someone thinks to look.
• Missed modifier 25. The E/M line denies outright on a visit your dermatologist already performed and documented.
• Repair coded as simple when the surgeon performed a layered closure. The note said closed, and the claim defaulted down.
• Destruction base codes stacked instead of add-ons. This one denies on the first claim, then repeats every week until someone rebuilds the charge template.

Notice what these share. Not one is a coder failing to know a code. Each is a gap between what happened in the room and what the note recorded, which changes the question you should be asking a billing company.

What to ask a billing company before you sign

1. Do your coders work dermatology specifically, or rotate across specialties?
2. How often do you refresh NCCI edit files in the clearinghouse, and can you show me the current version?
3. Do you sample notes against claims for undercoding, or only work denials?
4. What is your first-pass clean claim rate, and how do you calculate it?
5. Is credentialing handled by the same team, and what does it cost per payer?

Question 3 separates most vendors. Working denials is reactive by definition, and undercoding produces no denial to work. Question 5 matters more than practices expect, because an unenrolled provider cannot bill at all while claims age into an aged claim recovery workflow.

What MedSole charges, and what that rate covers

MedSole RCM operates at 2.99% of collections for full-service medical billing, and that rate covers eligibility verification, coding review, claim submission, payment posting, denial management, AR follow-up, and reporting with no separate charge for any of them.

Provider credentialing and payer enrollment is $99 per payer, including initial credentialing, re-credentialing, NPI registration, and CAQH maintenance. No minimum volume, no long-term contract.

Dermatology practices comparing billing partners see percentage rates quoted between 4% and 8% of collections, with credentialing billed on top as a separate line. The comparison that matters is not the headline percentage. It is what the percentage includes and what enrollment adds after it.

Want to know whether undercoding is running in your practice right now? Pull 30 excision notes from last quarter and read the documented measurements against the codes that went out. If they do not match, that gap has been open for as long as your template has. Specialty billing support at 2.99%

Frequently Asked Questions About Dermatology CPT Codes

What are the CPT codes for dermatology?

Dermatology CPT codes group into eight families: office visit E/M codes 99202-99215, skin biopsies 11102-11107, lesion destruction 17000-17004 and 17110-17111, lesion excisions 11400-11646, Mohs micrographic surgery 17311-17315, wound repairs 12001-13160, surgical pathology 88304-88341, and phototherapy 96900-96913 with photodynamic therapy 96567. Each family selects codes on a different variable, so technique drives biopsies while lesion count drives destruction and excised diameter drives excisions.

What CPT code is used for a skin biopsy?

Skin biopsy reports one of three base codes chosen by technique: 11102 for tangential or shave biopsy, 11104 for punch biopsy, and 11106 for incisional biopsy. Additional lesions sampled in the same session use the matching add-on codes +11103, +11105, and +11107. Codes 11100 and 11101 were deleted January 1, 2019, and still appear on outdated dermatology code lists.

What are the CPT codes for dermatology in 2026?

The eight code families stayed intact for 2026. Two changes affect dermatology: CPT 10040 was revised from acne surgery to extraction, the only revision in the Integumentary System section, and new surface radiation therapy codes 77436 through 77439 replaced the prior superficial radiation reporting structure for cutaneous tumors.

How do I bill multiple skin biopsies in one visit?

Report one primary code from the 11102 to 11107 range per encounter regardless of how many techniques the provider used, then add the add-on code matching each additional lesion's technique. A punch biopsy of one lesion plus a shave biopsy of a second reports 11104 and +11103. Document each lesion's anatomic site and technique separately.

What is modifier 25 and why does it matter in dermatology?

Modifier 25 identifies a significant, separately identifiable E/M service performed on the same day as a procedure, and it goes on the E/M code rather than the procedure code. HHS-OIG sampled 100 Medicare dermatology E/M claims billed alongside same-day minor procedures and found 10 that failed to meet Medicare documentation requirements. The pattern is legitimate, and the documentation carries the risk.

What is the CPT code for a dermatology skin check?

No dedicated code exists. Full body skin examinations report through office visit E/M codes, 99202-99205 for new patients and 99212-99215 for established patients, with the level set by medical decision-making or total time. Asymptomatic screening pairs with ICD-10 code Z12.83, and coverage for that diagnosis varies by plan.

How many CPT codes changed in 2026?

The AMA's CPT 2026 code set contains 418 total changes: 288 new codes, 84 deletions, and 46 revisions, effective January 1, 2026. Dermatology saw one revision inside the Integumentary System section, CPT 10040, plus the addition of surface radiation therapy codes 77436 through 77439.

What is the difference between biopsy and excision coding?

Biopsy codes select on technique, and excision codes select on pathology, anatomic site, and excised diameter. Perform both on the same lesion at the same encounter and NCCI includes the biopsy in the removal, so only the excision reports. Biopsy a different lesion than the one you excised and both codes stand, provided the note identifies each lesion.

Are cosmetic dermatology procedures covered by insurance?

Generally no. Coverage depends on a documented medical indication supported by an ICD-10 code, so a benign skin tag removed for appearance will not pay while the same procedure performed for irritation or bleeding can. Cosmetic encounters report Z41.1 and stay patient-pay. Documenting the medical indication at the time of service, rather than reconstructing it after a denial, is what protects the claim.

What does dermatology billing cost?

MedSole RCM charges 2.99% of collections for full-service medical billing, covering eligibility verification, coding review, claim submission, payment posting, denial management, AR follow-up, and reporting. Provider credentialing runs $99 per payer, including initial credentialing, re-credentialing, NPI registration, and CAQH maintenance, with no minimum volume and no long-term contract. Dermatology practices comparing vendors see 4% to 8% quoted with credentialing billed separately. Specialty billing support covers the full revenue cycle under that single rate.

Getting Dermatology CPT Coding Right

Dermatology coding is hard for a specific reason. Four variables drive four code families, and the documentation has to carry all four before the claim leaves your office.

Accurate dermatology CPT coding depends on precise documentation of technique, lesion count, size, and medical necessity. If your denials keep landing in the same place, that is a pattern worth reading rather than reworking.