Document 6546268

2013 Coding and
Documentation Manual
for Dermatology
There are many manuals that offer the
latest CPT information; the AMA publishes
its own, as do various companies. Are you
curious about what codes have been added
or redefined in CPT 2013? All of the changes
are listed in Appendix B of the AMA manual.
The AAD offers a dermatology-specific coding manual that includes all of the dermatology-relevant CPT updates; as a bonus, it also
includes guides for dermatologists to use in
participating in Medicare’s various incentive and reporting programs and tips for
handling audits.
Lastly, one may wonder, “When is the
updated CPT released every year?” The CPT
updates are typically available in October of
each year but its new/revised codes go into
use on Jan. 1. So if you haven’t purchased a
new coding manual, the time is now. You can
order the Academy’s coding manual online at
www.aad.org/storeorcall(866)503-SKINto
order it.
Interestingly, the new year’s ICD diagnostic codes are also released in October.
However, the ICD codes become effective on
Oct. 1. That is why when ICD-10 rolls in it
willbeactivatedonOct.1,2014ratherthan
Jan. 1, 2015. Peculiar, but true. (Learn more
about implementing ICD-10 at www.aad.org/
ICD10.) In subsequent issues of Cracking the
Code, I will endeavor to explain specific peculiarities and challenges of CPT coding. dw
ICD-9-CM Express Coder
LABORATORY
99000 Handling/specimen transfer
MICROBIOLOGY
87070 Bacterial culture
87075 Aerobic culture
87101 Fungi, mold, yeast, skin, hair, nail
87205 Stain: Gram, Giemsa
87207 Inclusion bodies/parasites
87209 Complex Stain
87210 KOH, wet mount
87220 KOH, fungi, ova, mites
CHEMICAL PEEL
15788 Facial, epidermal
15789 Dermal
DEBRIDEMENT
11000 Eczema, infected skin, up to 10%
11001 Each additional 10%
11042 Subcutaneous, first 20 sq cm
11045 each add’l 20 sq cm
11720 Nails, any method 1-5
11721 Nails > 6
Nail Matrix
SURGICAL PATHOLOGY
11730 Avulsion nail plate part/
complete simple; single
11732 Each additional nail plate
11750 Excise nail & matrix/part/
complt perm removal:
11752 W/amputation tuft distal phalanx
MEDICINE ALLERGY
17106 Cutaneous vascular prolife
rative lesion; < 10 sq cm
17107 10.0 cm to 50.0 sq cm
17108 > 50 sq cm
17110 Flat wart, molluscum
contagiosum, milia; 1-14 lesions
17111 > 15 lesions
17250 Chemical cauterization,
granulation tissue
46916 Anus, simple; cryosurgery
54050 Penis, simple; chemical
54055 Electrodesiccation
54056 Cryosurgery
54057 Laser surgery
54060 Surgical excision
54065 Destruction of lesion, penis, extensive
88300 Gross exam only, Level 1
88302 Gross + micro exam, Level 2
88304 Skin, cyst, tag, Level 3
88305 Skin, other, Level 4
88329 Path Consult during surgery
88331 1st tissue block w/frozen section,
single spec.
88332 Each additional tissue block w/frozen
section
88333 Path Consult (Touch Prep)
88346 Immunofluorescent study, each ant.
body, direct
95044 Patch/application tests; # (specify number)
95052 Photopatch test # (specify number)
DERMATOLOGY PROCEDURES
96900 Actinotherapy (Ultraviolet light)
96902 Microscopic examination of hair
96904 Whole body integumentary photography
96910 Photochemotherapy, tar,
petroleum + UVB
96912 Psoralens & UVA (PUVA)
96913 Photochemotherapy TX, 4-8
hours with physician supervision
96920 Laser Treatment of psoriasis,
< 250 sq cm
96921 250 – 500 sq cm
96922 over 500 sq cm
INJECTIONS/INTRODUCTIONS
G9142
Influenza A (H1N1) vaccine, any admin route
96372 Injection, IM/subq
11900 Intralesional; < 7 lesions
11901 7 lesions
11950 Subcutaneous filling mat; = < Icc
96365 Infusion Therapy < hour
96366 Infusion Therapy (each hour, up to 8)
96372 Intramuscular/Subcutaneous (IM)(SC)
(specify drug)
96374 Intravenous (IV)
SURGICAL SERVICES
Adjacent Tissue Transfer/
Rearrangement
14000 Trunk; defect = < 10 sq cm
14020 Scalp/arm/leg = < 10 sq cm
14040 Forehead/chin/cheek/mouth/neck/
axillae genitalia/hand/foot < 10 sq cm
14060 Lid/nose/ear/lip = < 10 sq cm
14301 any area defect size 30.1-60.0 sq cm
14302 each additional 30.0 sq cm, or part
thereof
Chemodenervation (Hyperhydrosis)
64650 Both axillae
64653 Scalp, face, neck, per day
64999 Unlisted procedure: feet or hands
BIOPSY
11100 Skin/subcutaneous tissue
mucous membrane, 1 lesion
11101 Each additional, separate lesion
11755 Nail unit, any method
40490 Lip incl. only vermilion/mucosal area
54100 Penis
56605/6
Vulva or perineum
67810 Eyelid incl. lid margin, tarsal plate, or
palpebral conjuctiva
69100 External ear
DESTRUCTION LESION
Premalignant Lesion
17000 With local anesthesia, one lesion
17003 2nd through 14th lesion
17004 15 or more lesions
Benign Lesions
Malignant
17260
17261
17262
17263
17264
17266
17270
17271
17272
17273
17274
17276
17280
Trunk/arm/leg < 0.5 cm
0.6 to 1.0 cm
1.1 to 2.0 cm
2.1 to 3.0 cm
3.1 to 4.0 cm
> 4.0 cm
Scalp/neck/hand/foot/genitalia < 0.5 cm
0.6 to 1.0 cm
1.1 to 2.0 cm
2.1 to 3.0 cm
3.1 to 4.0 cm
> 4.0 cm
Face, ear, eyelid, nose/lip/
mucous membrane < 0.5 cm
17281 0.6 to 1.0 cm
17282 1.0 to 2.0 cm
17283 2.1 to 3.0 cm
17284 3.1 to 4.0 cm
17286 > 4.0 cm
EXCISION, LESION
Benign Lesion, Including Margins
11400
11401
11402
11403
11404
11406
11420
11421
11422
11423
11424
11426
11440
Trunk/arm/leg < 0.5 cm
0.6 to 1.0 cm
1.1 to 2.0 cm
2.1 to 3.0 cm
3.1 to 4.0 cm
> 4.0 cm
Scalp/neck/hands/feet/genitalia < 0.5 cm
0.6 to 1.0 cm
1.1 to 2.0 cm
2.1 to 3.0 cm
3.1 to 4.0 cm
> 4.0 cm
Face/ear/eyelids/nose/lips/
mucous membranes < 0.5 cm
11441 0.6 to 1.0 cm
11442 1.0 to 2.0 cm
11443 2.1 to 3.0 cm
11444 3.1 to 4.0 cm
11446 > 4.0 cm
Malignant Lesion, Including
Margins
Shaving, Lesion
11300 Trunk/arms/legs. 1 lesion; lesion =
< 0.5 cm
11301 0.6 to 1.0 cm
11302 1.1 to 2.0 cm
11303 > 2.0 cm
11305 Scalp/neck/hand/ft/genit.
1 les: les = < 0.5 cm
11306 0.6 to 1.0 cm
11307 1.1 to 2.0 cm
11308 > 2.0 cm
11310 Face/ears/eyelids/nose/lips/
muc memb: lesion = < 0.5 cm
11311 0.6 to 1.0 cm
11312 1.0 cm
11600 Trunk/arms/legs: < 0.5 cm
11601 0.6 to 1.0 cm
11602 1.1 to 2.0 cm
11603 2.1 to 3.0 cm
11604 3.1 to 4.0 cm
11606 > 4.0 cm
11620 Scalp/neck/hands/feet/
genitalia: = < 0.5cm
11621 0.6 cm to 1.0 cm
11622 1.1 to 2.0 cm
11623 2.1 cm to 3.0 cm
11624 3.1 cm to 4.0 cm
11626 > 4.0 cm
11640 Face/ear/eyelids/nose/lips/
mucous membranes: < 0.5 cm
11641 0.6 to 1.0 cm
11642 1.1 to 2.0 cm
11643 2.1 to 3.0 cm
11644 3.1 to 4.0 cm
11646 > 4.0 cm
Skin Graft
Mohs Micrographic Surgery
17311 1st stage, head/neck/hands/feet/genitalia
17312 Additional stage
17313 1st stage, trunk/arms/legs
17314 Additional stage
17315 Each additional block, any stage
Incision/Drainage
Skin Tag Removal
10040 Acne surgery
10060 Abscess: simple/single
10061 Complicated/multiple
11200 Any area; = < 15 les
11201 Each additional 10 lesions
Strapping
Other Procedures
29580 Unnaboot application
29581 Multi-layer compression bandage
application, below knee
17360 Chemical exfoliation for acne
17340 Cryotherapy for acne
Paring/Cutting
Venipuncture
11055 Benign hyperkeratotic lesion; 1
11056 2 to 4
11057 > 4
36416 Collection capillary blood finger/heel/ear
36415 Collection venous blood by
venipuncture
Repair, Complex
13100 Trunk; l.l cm to 2.5 cm
13101 2.6 cm to 7.5 cm
13102 Each additional 5 cm or less
13120 Scalp/arms/legs: 1.1 cm to 2.5 cm
13121 2.6 to 7.5 cm
13122 Each additional 5 cm or less
13131 Forehead/cheek/chin/mouth/axilla/neck/
genit/hands/foot: 1.1 cm to 2.5 cm
13132 2.6 to 7.5 cm
13133 Each additional 5 cm or less
13150 Eyelids/nose/ears/lips: < 1.0 cm
13151 1.1 to 2.5 cm
13152 2.6 to 7.5 cm
13153 Each additional 5 cm or less
Repair, Intermediate
12031 Scalp/axila/trunk/extrem
(exclud hands/foot); < 2.5 cm
12032 2.6 to 7.5 cm
12034 7.6 to 12.5 cm
12035 12.6 to 20.0 cm
12041 Neck/hand/foot/external
genitalia; = < 2.5 cm
12042 2.6 to 7.5 cm
12044 7.6 to 12.5 cm
12045 12.6 to 20.0 cm
12051 Face/ear/eyelid/nose/lip/
mucous membrane: < 2.5 cm
12052 2.6 to 5.0 cm
12053 5.1 to 7.5 cm
12054 7.6 to 12.5 cm
12055 12.6 to 20.0 cm
Sclerosing Injection
15002 Surgical prep recipient site trunk/
arms/legs
15003 Each additional 100 sq cm
15004 Surgical prep recipient site
face/scalp/eyelids/mouth/neck/ears/etc
15005 Each additional 100 sq cm
15200 Full thickness, free, incl dir clos;
trunk, = < 20 sq cm
15220 Scalp/arm/leg; = < 20 sq cm
15240 Forehead/cheek/chin/mouth/neck/axila/
genit/hand/ft: < 20 sq cm
15260 Nose/ear/eyelid/lip: = < 20 sq cm
15740 Flap, island pedicle
15750 Flap, neurovascular pedicle
E/M SERVICES
Office/New Patient
99201 Self limiting, minor 10 min
99202 Self limit-low/mod complexity 20 min
99203 Mod severity 30 min
99204 Mod severity 45 min
99205 Mod-high severity 60 min
Office/Established Patient
99211 No phys supv 5 min
99212 Self-limit minor 10 min
99213 Low-mod severity 15 min
99214 Mod-high severity 25 min
99215 Mod-high severity 40 min
Consult/Outpatient,
New/Established Patient
E/ M Pocket Pro
36468 Spider veins, single/multiple: limb/trunk
36469 Face
36470 Single vein
36471 Multi vein, same leg
99241 Self limit/minor 15 min
99242 Low severity 30 min
99243 Mod severity 40 min
99244 Mod-high severity 60 min
99245 Mod-high severity 80 min
Consult/Inpatient,
New/Established Patient
99251 Initial visit: minor 20 min
99252 Low severity 40 min
99253 Mod severity 55 min
99254 Mod-high severity 80 min
99255 Mod-high severity 110 min
Pre-Order
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Supplies
Injections
J0585 Botulinum toxin, Type A per Unit
J0702 Betamethasone acetate &
sodium phos 3 mg
J0704 Betamethasone sodium phos 4 mg
J1100 Dexamethasone sodium phos 1 mg
J9040 Bleomycin sulfate 15 units
J9260 Methotrexate sodium 50 mg
J3301 Triamcinolone acetonide per 10 mg
J3302 Triamcinolone diacetate per 5 mg
J3303 Triamcinolone hexacetonide per 5 mg
J3490 Unclassified drugs
Miscellaneous
99070 Supply/mat provided by phys.
not incl w/visit/other serv
A4550 Surgical trays
A9270 Non-covered service
CPT only © 2010 American Medical Association. All Rights Reserved.
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RESOURCES
Copyright © 2012 American Academy of Dermatology. All rights reserved.
Dermatology WorlD // January 2013
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