Wiki Full body skin check as preventative

[mzavorski15]

I am new to derm and my manager is asking about billing full body exams as preventative and an E/M code if they find something. I have been researching and it looks like a derm specialty office should be billing E/M codes. But all the information I am finding is dated. She believes this is new this year. Anyone know anything about this and can guide me to a resource?

 

[thomas7331]

Skin cancer screening is not one of the services that is recommended by the USPSTF, so it is not a service that any payer is required to cover, and I've never encountered one that offers this as a preventive benefit. Since an annual full preventive physical by a PCP, which would include a skin exam, is covered by all payers now, I don't know why any payer would feel it useful to pay for an additional screening by a specialist when that has not been proven by studies to improve outcomes. I'm not aware of any new coverage rules for this year, and to my knowledge there isn't a CPT code specifically for a skin cancer screening exam, so if you're going to bill this I think you'd have to use an unlisted code.

In my opinion, it is inappropriate to bill this service using an E&M code because a screening is not an E&M service - E&M involves the evaluation and management of a problem and a chief complaint is required. A screening or preventive service, by definition, means that the patient has no symptoms or complaint.