According to Inga Ellzey, History of Malignant Melanoma is No Longer Considered a “Chronic” Condition, Will Not Generate 99214 Level EM Visit
CASSELBERRY, FL, June 06, 2022 /24-7PressRelease/ — Inga Ellzey Billing Companies’ Dermatology Billing Associates, the top-rated company providing outsourced billing services to dermatology practices nationwide, is warning practitioners that new office coding guidelines are causing medical billing errors for many dermatology clinics.
The American Medical Association’s new coding and documentation guidelines became effective on January 1, 2021. While the updated guidance was intended to simplify code selection and allow physicians to spend less time documenting and more time caring for patients, their use has coincided with an increasing number of medical billing errors among dermatology practices. A history of skin cancer is now classified as a minor condition because it is history. The malignant lesion has been removed, and it is now a scar. It is not considered a chronic condition.
As such, billing a 99214 level EM based on “history” is incorrect billing. With the new guidelines based on medical decision-making, a history of skin cancer with counseling/reassurance meets 99212 if that is all that is documented. If there is a recurrence of malignancy, the lesion will be treated as needed, resulting in a procedure code such as a biopsy, shave removal, then excision or Mohs.
“Keep in mind with the 2021 guidelines that you must meet at least two of three of the Medical Decision-Making categories,” says Inga Ellzey. “With ‘history of skin cancer’ being a minor condition and counseling regarding sunscreen being in the low-risk category, you do not meet two of three to support 99214.”
About Inga Ellzey and Dermatology Billing Associates
With offices in California and Florida, the Inga Ellzey team is comprised of 145 American-based employees, with an average tenure of 7.5 years. Serving over 475 providers in 101 practices across 37 states, Dermatology Billing Associates is always there, wherever and whenever their clients require assistance.
With over 40 years of extensive experience in dermatology, Inga is the nation’s foremost expert on dermatology coding, documentation, reimbursement, and billing. She holds a Master’s Degree in Public Administration, a Bachelor’s Degree in Medical Record Administration, and is a Registered Health Information Administrator.
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