Dermatology is a complex specialty and closely linked to pathology. Understanding both specialties is essential to successful reimbursements.

Consider a patient with Actinic Keratosis. You’ve performed a skin lesion removal and sent the samples to a pathologist. Should you submit your claims with your findings or wait for the pathologist report? Say, the patient returns and now must you use diagnoses that you used previously or not? If you plan to use a V-code (e.g. V10.82 or V10.83) to represent history of malignant lesions, should they be your primary diagnoses or secondary? What impact does “malignant lesions” have on a patient’s longterm coverage?

Similarly, say Cigna has been denying whenever you performed wart removals (e.g. 17110 and 17000-59) with a 59 modifier (to indicate distinct procedures). How do you approach this case? Do you not bundle them this way or do you submit medical records or negotiate with Cigna?

We focus on specialties precisely to answer these questions before the physician needs to. Our dermatology teams undergo training specific to clinical knowledge of dermatology that helps them understand what their clients do. This allows us to submit cleaner claims and get our clients paid correctly and quickly.