Who We Are We are Prime Medical Billing Solutions, LLC, a results-driven medical billing and revenue cycle partner headquartered in Atlanta, Georgia. Since about 2015, we have operated with the belief that true value lies in partnering, rather than merely contracting, with providers to ensure personalized attention and peak revenue performance. Founded by seasoned billing professionals with 20+ years of combined expert experience, our home office in Atlanta supports both individual practices and larger provider groups. Our team is passionate about maximizing reimbursements and simplifying the billing journey step by step. What Services We Offer We provide a comprehensive suite of services designed to optimize every phase of the revenue cycle: Claims processing & billing management, including electronic, UB‑04, and HCFA‑1500 formats Accounts receivable and collections, focusing on paid-to...
Dermatology Billing & Coding Services
Biopsies, lesion destruction, excisions and Mohs surgery each have their own measurement and modifier rules. Specialist dermatology billers make sure each lesion is coded and paid correctly.
- Lesion size, site and margin-based excision coding
- Correct biopsy method codes and add-on units
- Medical vs. cosmetic separation with clear patient billing
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What makes dermatology billing complex
Dermatology procedures are coded by method, size and location. A biopsy is coded differently for tangential, punch and incisional techniques; excisions depend on whether the lesion is benign or malignant, its anatomic site and its excised diameter including margins; and repairs are coded by length and complexity.
Many visits combine a problem-oriented E/M with one or more procedures, which requires modifier 25 and clear documentation. Multiple lesions on the same day need the right add-on codes and modifiers such as 59 or XS, and Mohs surgery has its own stage-based coding with strict rules about who performs pathology.
Dermatology practices also offer cosmetic services that insurance does not cover. Keeping medical and cosmetic billing separate, with proper patient consent and payment collection, protects revenue and compliance. A dermatology billing team handles all of this, plus pathology reconciliation and denial follow-up.
Common dermatology billing challenges
Lesion size and margin rules
Excision codes depend on the lesion diameter plus margins, as documented before excision.
Biopsy method coding
Tangential, punch and incisional biopsies have separate codes and add-on codes for additional lesions.
Modifier 25 and 59 scrutiny
Same-day E/M and multiple procedures are frequent payer audit targets.
Destruction code counts
Premalignant lesion destruction uses tiered codes by count that are easy to misapply.
Mohs surgery rules
Stages, blocks and repairs must be coded precisely, often with modifier 51 exemptions and add-ons.
Cosmetic vs. medical services
Non-covered cosmetic procedures need separate pricing, consent and patient payment workflows.
What a dermatology billing partner should handle
- Lesion-level coding from procedure notes
- Biopsy, excision, destruction and repair coding
- Mohs micrographic surgery coding
- Modifier 25, 59/X{EPSU} documentation review
- Pathology result and diagnosis reconciliation
- Prior authorization for phototherapy and biologics
- Cosmetic service and patient-pay management
- Denial management and appeals
- Patient statements and payment plans
- Provider coding feedback and audits
Key codes in dermatology billing
| Code(s) | What it covers |
|---|---|
| 11102–11107 | Tangential, punch and incisional skin biopsies, first lesion and each additional. |
| 11400–11646 | Excision of benign (114xx) and malignant (116xx) lesions by site and excised diameter. |
| 17000–17004 | Destruction of premalignant lesions such as actinic keratoses, by count. |
| 17110 / 17111 | Destruction of benign lesions like warts, up to 14 / 15 or more. |
| 17311–17315 | Mohs micrographic surgery, first and additional stages by site. |
| 12001–13153 | Simple, intermediate and complex wound repair by length and site. |
| 96910 / 96900 | Photochemotherapy and ultraviolet light therapy. |
Code examples are for orientation only. Always code from the current CPT®, HCPCS and ICD-10-CM code sets and payer policies.
Code after pathology when needed
For excisions, malignancy determines the code family. Many dermatology billers hold excision claims until the pathology report confirms benign or malignant, avoiding corrected claims and denials.
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How much does dermatology billing cost?
Most billing companies charge a percentage of what they actually collect, so their incentive matches yours. Complex specialties sit at the higher end of the range because of prior authorizations, modifiers and appeal work.
Most common. You pay only on money collected.
Predictable for high-volume, low-complexity claims.
Dedicated billers working inside your systems.
Typical market ranges; actual quotes depend on claim volume, payer mix and scope. Compare quotes from several companies.
Dermatology billing FAQs
By technique, tangential (11102), punch (11104) or incisional (11106), with add-on codes for each additional lesion biopsied.
Excision codes use the excised diameter: the lesion’s greatest clinical diameter plus the narrowest margins required, measured before excision.
When a significant, separately identifiable E/M service is performed on the same day as a minor procedure and is documented as such.
Yes. Mohs is billed by stage and anatomic site with 17311–17315, when the same physician acts as surgeon and pathologist.
Cosmetic services are kept separate from insurance claims, with clear patient pricing and collection at the time of service.
Most companies charge around 4% to 8% of collections.
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