Can You Bill Separately for Puracol Collagen Dressings?
No, Puracol collagen is not separately billable as a supply. It is classified as a dressing under HCPCS and is generally included in the overall service. However, the application of the product may be reportable using the appropriate CPT 1527X series code when it meets the definition of a skin substitute application. Why This Matters […]
Are You Urgently Addressing Emerging Legal and Compliance Risks Related to PA and APRN Supervision?
Healthcare organizations are facing growing legal and compliance risks as state laws continue to evolve around Physician Assistant (PA) and Advanced Practice Registered Nurse (APRN) supervision, scope of practice, credentialing, and licensure. While many of these changes were introduced during or after the COVID-19 public health emergency to expand access to care, they have also […]
When is an E/M Service Considered Separate and Distinct from a Dermatology Procedure Performed on the Same Day?
An E/M service is considered separate and distinct from a dermatology procedure when the provider performs and documents a significant, separately identifiable evaluation and management service that goes above and beyond the work normally included in the procedure. In these cases, the E/M service may be reported with modifier 25 in addition to the procedure. Importantly, CMS […]
High-Risk Liability Areas in Aesthetic and Dermatology Practices
As aesthetic and dermatology services continue to expand, so does regulatory scrutiny and liability exposure. While many procedures are viewed as routine or low-risk, the consequences of inadequate supervision, poor documentation, or scope-of-practice violations can be significant. Understanding where risk exists, and implementing safeguards to address it, are essential for protecting patients, providers, and organizations. […]
Getting Telehealth Documentation Right: 3 Details That Matter
A strong telehealth note should capture not just the clinical work, but the context of the visit. For telehealth E/M services, three simple details can make a meaningful difference for billing and compliance: how the visit happened, where the patient was, and whether the patient or guardian agreed to receive care via telehealth. 1. Modality: […]
Eliminating Preventable Denials and Mitigating Medical Necessity Challenges in Dermatology
Healthcare industry benchmarking surveys have reported that denial rates for dermatology practices average 14%, which is significantly higher than the 5% – 8% benchmark for medical practices. Following our recent presentation at the Dermatology Manager’s Association Annual Conference surrounding payer denials, one issue continues to stand above the rest: medical necessity. Many denials and payment issues are controllable and preventable, but payer denials for […]
New Immunization Counseling Codes: Added Revenue Opportunities for Pediatric Providers
The American Medical Association (AMA) has announced new CPT codes (90482–90484) for immunization counseling — offering pediatric providers a new way to capture reimbursement for valuable time spent counseling patients and families about vaccines, even when immunizations are deferred, declined, or the patient is underimmunized. These codes, detailed in the March 2026 CPT® Assistant (Issue […]
Important Update: New Medicare Advance Beneficiary Notice (ABN) Now Approved
CMS has announced an update to the Medicare Advance Beneficiary Notice of Non-coverage (ABN), Form CMS-R-131, now approved by the Office of Management and Budget (OMB). The newly revised ABN is effective immediately and valid through March 31, 2029. The ABN helps beneficiaries make informed decisions when services or supplies may not be covered by Medicare. Providers are […]
Superficial Radiation Therapy 2026 CPT Code Overhaul: An Updated Guide for Dermatology Practices
The landscape for billing and coding Superficial Radiation Therapy (SRT) is undergoing a significant shift. With the 2026 CPT code updates, the American Medical Association has completely restructured how these [...] Unmatched Expertise in Healthcare Consulting: Your Partner for Compliance & Growth
In the ever-evolving landscape of healthcare, navigating complex regulations, optimizing revenue integrity, and ensuring bulletproof compliance requires more than just a consultant—it demands a seasoned team with deep, collective expertise. [...] 