Dermatology Coding Alert

Published on Tue Jul 28, 2009 PDF

Question: A patient says her insurance provider did not pay our bill for her yearly skin exam because we "didn't have the wellness code down." She had her first exam and diagnosis last year; should we have reported a V code instead?

Texas Subscriber

Answer: Yes, a V code might be a better choice, especially if the patient has a history of skin cancer. In those cases, consider V76.43 (Special screening for malignant neoplasms; skin) for visits your dermatologist documents as a "skin check." If the patient's original screening was malignant, list the screening code as primary and a personal history code such as V10.82 (Personal history of malignant neoplasm of other sites; malignant melanoma of skin) or V10.83 (... other malignant neoplasm of skin) second.

"Worried well": What if the patient returns several times each year because she is worried about skin cancer but has no signs of it? Submit V65.5 (Person with feared complaint in whom no diagnosis was made) as the diagnosis or code based on any symptoms listed in the patient's HPI.