tci Outpatient Facility Coding Alert - 2014 Issue 2

Dermatology: Get Paid for Scar Procedures By Proving They're Medically Necessary

Tip: Documentation should show that excisions are a part of aftercare. If you’re having trouble recouping scar revision pay, you may need a refresher on how to establish medical necessity for aftercare procedures and how to report tissue transfers. Our expert advice can help you master scar revision coding basics. Demonstrate Medical Necessity Most payers will not cover cosmetic scar revisions, so you should make sure the dermatologist establishes medical necessity for the procedure. In many cases, patients with function-impeding scars present with scars around their eyes or mouth. For example, a patient with a basal cell carcinoma...

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