CPT Codes 2018: Dermatology Coding Updates

by Wendy Rogers | May 24, 2018 |

Some of the top dermatology CPT code changes

A few changes and new codes included in the American Medical Association (AMA) 2018 CPT® Professional book impact dermatology. Descriptors for some CPT codes were updated, along with new CPT codes to better show a provider’s direct involvement in the treatment or procedure.

Please note that the descriptors detailed below for each of the dermatology CPT codes were sourced directly from the AMA 2018 CPT Professional book.

One update includes a revision to CPT code 96567 which includes editorial changes and introduces two new codes.

Photodynamic Therapy (PDT)

  • Per the AMA’s CPT 2018: Professional Edition book, 96567 is for Photodynamic therapy (PDT) by external application of light to destroy premalignant lesions of the skin and adjacent mucosa with application and illumination/activation of photosensitive drug(s), per day.
    • Per the AMA’s CPT 2018: Professional Edition book, they recommend not using this code when a physician or qualified healthcare provider is not directly involved in providing the PDT treatment. This is a revised code.  
  • Per the AMA’s CPT 2018: Professional Edition book, 96573 is for PDT by external application of light to destroy premalignant lesions of the Understanding Phototherapy Services skin and adjacent mucosa with application and illumination/activation of photosensitizing drug(s) provided by a physician or other qualified healthcare professional, per day. Per the 2018 CPT book published by AMA, they recommend not reporting 96567, 96574 with 96573 for the same anatomic area.  
  • Per the AMA’s CPT 2018: Professional Edition book, 96574 is for Debridement of premalignant hyperkeratotic lesion(s) (i.e. targeted curettage, abrasion) followed with photodynamic therapy by external application of light to destroy premalignant lesions of the skin and adjacent mucosa with application and illumination/activation of photosensitizing drug(s) provided by a physician or other qualified healthcare professional, per day. Per the 2018 CPT book published by AMA, they recommend not reporting 96567 or 96573 with 96574 for the same anatomic area. This is a new code.

The first new PDT code 96573 will help identify PDT and where the photosensitizing agent is applied by the physician or by another qualified healthcare provider. Whereas, the second PDT code 96574 will address photodynamic therapy when the provider debrides hyperkeratotic lesions prior to treatment.

Chemical Cauterization

  • Per the AMA’s CPT 2018: Professional Edition book, 17250 for chemical cauterization of granulation tissue now includes only proud flesh, deleting sinus or fistula from the description.

Wound Reconstruction (Flap)

  • Per the AMA’s CPT 2018: Professional Edition book, 15730 has been added to describe Midface skin flap reconstruction (i.e., zygomaticofacial flap) with preservation of vascular pedicle(s).
  • Deleted 15732 for Muscle, myocutaneous or fasciocutaneous flap head and neck. This is a deleted code as per the AMA’s CPT 2018: Professional Edition book.
  • Per the AMA’s CPT 2018: Professional Edition book, 15733 (replaces 15732) for Muscle, myocutaneous or fasciocutaneous flap; head and neck with named vascular pedicle (i.e. buccinators, genioglossus, temporalis, masseler, sternocleidomastoid, levator scapulae).

Healthcare Common Procedure Coding System (HCPCS)

  • New HCPCS Drug Code for Tremfya for treatment of severe plaque psoriasis C9029 Injection, guselkumab, 1mg as per the AMA’s CPT 2018: Professional Edition book

Our dermatology EHR system, EMA™, reflects these updates as the dermatology CPT codes are automatically generated. When your practice has access to the most up-to-date coding guidelines and information about regulations, you may have the potential to obtain maximum reimbursements. Such automatic coding can help increase efficiencies and productivity in your practice.

Interested in learning more about EMA?

Source

The American Medical Association. CPT® 2018: Professional Edition. 2017. Print.

Wendy Rogers, CPC, CPC-P, CASCC, AAPC Certified Instructor, MA

Wendy Rogers, CPC, CPC-P, CASCC, AAPC Certified Instructor, MA

RCM Coding and Compliance Lead

Wendy joined the Modernizing Medicine team in 2015 bringing over 18 years of medical coding and billing experience in various specialties. She currently serves as the RCM Coding and Compliance Lead for Modernizing Medicine where she oversees the RCM coding and auditing team which consists of experienced and knowledgeable certified coders. As a certified professional in the field, she holds CPC, CPC-P, CASCC and AAPC Certified Instructor certifications in addition to her Associates Degree in Medical Assisting.

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