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Malpractice, billing fraud, and negligence in medical coding are the real threat to your healthcare practice. Which can land medical practitioners in hot water, legally and financially. Therefore, it is very important to ensure compliance in your healthcare practice and particularly lab dermatology billing. Because it is the prime area, which requires particular attention and skills to take care of. All the time, we discuss the impact of inefficient dermatology medical billing. Because, it leads to excessive claim denials, partial or delayed reimbursements. It's true, but have you ever thought about its legal aspect? Even small negligence in assigning the procedural or diagnostic medical codes can trigger a fraud investigation. 

For instance, coding errors such as; unbundling, under coding and upcoding are serious trouble for the practitioners. All these errors occur when providers try to manipulate the reimbursements from the insurance companies (both government and private). It could be very frustrating and stressful for the dermatologists_even if they aren’t found guilty, simply facing a malpractice lawsuit. It can ultimately damage your reputation in the healthcare market, and may drastically impact your patient volume. Therefore it would be beneficial for the providers to adopt a proactive method to save their healthcare practice from such inconvenience in the present and future as well. Here are the following tips that can streamline your lab dermatology billing services and prevent malpractice. 

Malpractice in Billing

Submitting medical claims for the unmatched or the dermatology services you never provided is the major reason behind legal consequences. Hence in order to ensure the effectiveness and accuracy of the  dermatology medical billing processes and diminish the risk of malpractice, medical practitioners should adopt the following strategies; 

Accurate Clinical Documentation: One of the most effective dermatology billing solutions is error-free medical documentation. Because it is considered the foundation of the revenue cycle management. And in order to eliminate the billing and coding errors from the very beginning, ensure a high level of accuracy and specificity in your health records. For this purpose, industry experts suggest the automation of the documentation. For instance, integrating the EHR systems, not only helps you to shift your paper-based files into a digital form. But it can reduce the chances of errors. Moreover, an EHR system makes the entire procedure of data collection, processing, and exchange quite easy and manageable. Eventually when billers and coders get real-time access to the accuracy and precise medical information. They become better able to perform their jobs efficiently. Which keeps the lab dermatology billing process optimized. 

Keep Up With Modifier Changes

Incorrect modifiers to gain illegal reimbursements are the major obstacle to getting fair compensation. Moreover, it is also the biggest reason that could land health care providers in serious legal troubles. Make sure that your coding staff has a complete know-how of CPT modifiers and more importantly their accurate use. Below are the most commonly used modifiers that every dermatologist must know about: 

  • 59 –“Distinct Procedural Service”
  • XE –“Separate encounter, A service that is distinct because it occurred during a separate encounter”
  • XS –“Separate Structure, A service that is distinct because it was performed on a separate organ/structure”
  • XP – “Separate Practitioner, A service that is distinct because it was performed by a different practitioner”
  • XU –“Unusual Non-Overlapping Service, The use of a service that is distinct because it does not overlap usual components of the main service”

Modifier 25: This modifier is only used along with E/M CPT codes for established patients, not for new ones. 

Modifier 59: The 59 modifiers are attached to other dermatology CPT codes to indicate a service or procedure was distinct or separate from others performed on the same day. 

Final Note:

In order to streamline lab dermatology billing, you should never show reluctance in hiring and training the RCM staff. Because without the assistance of professionals, you cannot deal with the growing complexities in revenue collections management.  Make sure that you undergo constant training to stay at the top of the changes in terms of medical billing, coding, payers policies, and federal/state rules. Hence get the services of the industry experts, implement the right dermatology billing solutions and make your business profitable. 


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