Dermatology Coding Guidelines under ICD-10

With the introduction of ICD-10, that will have revised dermatology coding guidelines, dermatology billing will be more accurate and it will be easier to file clean claims. The procedure that is performed in the office determines the amount that needs to be charged by an outpatient dermatology practice. All the charges are related to specific procedure codes as complex procedures draw high reimbursement. This again is related to the practice and professional resources that are used to provide the service. The ICD-9 codes for dermatology are matched to the corresponding procedure code that implies medical necessity under the present reimbursement system.

But it has been seen for a long time that the required specificity to accurately report medical necessity lacks in ICD-9. Often, physicians assign Volume 2 codes without referring to the volume 1 codes, which usually happens to be an unspecified code, and the claim gets paid without any obstacles. But this doesn’t mean that it is a clean claim.

So when a coder or biller who is certified reviews the record, one can find a more appropriate code to describe the condition. Since ICD-9 has only 13,000 codes, most of the codes that are reported often turn out to be unspecified. But the new ICD-10 contains 68,0000 codes that will help to describe medical conditions specifically. This will help to determine medical necessity that will help in proper reimbursement.

For instance, under ICD-9 code 708.9 is used to report urticaria that has the medical description of “unspecified”. But with ICD-10 there will be separate procedure specific codes to describe the exact condition. For instance, L50.0 with the description: reaction to food, drugs or inhalants.  But if solar urticaria needs to be reported then L56.2 will be used.

Although this information will be contained in every medical record, only a professional biller or coder will be able to decode ICD-10 to assign the accurate codes for every documented diagnosis. If correct codes are assigned to bill, it will result in maximized reimbursement.

If you are looking for healthcare training conferences, AudioEducator is the place where you can choose a wide range webinars for dermatology coding guidelines and medicare guidelines an overview to stay compliant.