If you’re a healthcare provider offering laser procedures, it’s essential to know the ins and outs of laser procedure billing. In this article, we’ll provide you with a comprehensive guide on what you need to know to navigate laser billing services successfully. From understanding laser treatment codes to identifying potential billing errors, we’ll cover everything you need to know to ensure smooth and efficient billing for your laser procedures.
What is Laser Procedures Billing?
Laser procedures billing involves assigning the appropriate codes to the procedures performed during a patient’s visit. Proper coding ensures that the healthcare provider is reimbursed for the services rendered. The codes used for laser procedures billing are based on the Current Procedural Terminology (CPT) and the International Classification of Diseases (ICD).
Understanding Laser Procedure Codes
The first step in accurate billing for laser procedures is understanding the correct codes to use. Several different codes may apply, depending on the specific procedure they are performing. Some healthcare providers commonly use the following codes for laser procedures:
- CPT codes: Current Procedural Terminology (CPT) codes describe medical treatments and services. When it comes to laser procedures, there are several codes you need to know, such as:
- CPT Code 96900: Code 96900 is used for laser treatment of a single lesion or spot. You should report this code once for each lesion or spot treated.
- CPT Code 96910: 96910 code is used for laser treatment of multiple lesions or spots. Submit this code only once per session, regardless of how many lesions or spots they treat.
- CPT Code 96920: For laser therapy of a sizable area, use this code. Regardless of the size of the region treated, you should report this code only once each session.
- CPT Code 96999: Code 96999 code is used for laser procedures that are not covered by the specific codes mentioned above. You should use this code sparingly, only when there is no other appropriate code available.
Here are some more examples of common CPT codes:
- CPT code 66761 is used to describe a laser treatment for glaucoma.
- Moreover, CPT code 65778 is used to describe a laser treatment for retinal tears.
- CPT code 66982 is used for Cataract surgery with intraocular lens implantation and laser assistance
- CPT code67820 CPT code is used to describe the Destruction of the lesion(s), eyelid margin; up to 1 cm.
ICD-10 codes:
International Classification of Diseases, Tenth Revision (ICD-10) codes are used to describe diagnoses. It is used to classify diseases, injuries, and other health conditions for billing purposes. It is important to choose the correct ICD-10 code to support the medical necessity of the laser procedure.
A few examples of ICD-10 codes used for laser procedures are as follows:
- D22.9 – Melanocytic nevi, unspecified
- D23.3 – Other benign tumors of the trunk’s skin
- D48.5 – Skin neoplasm with unpredictable behavior
- L57.0 – Actinic keratosis
- L72.0 – Epidermal cyst
- L73.9 – Follicular disorder, unspecified
HCPCS codes:
Healthcare Common Procedure Coding System (HCPCS) codes are used to describe medical equipment, supplies, and services. Some laser procedures may require the use of specialized equipment or supplies, which may have their own HCPCS codes.
A few examples of HCPCS codes used for laser procedures are as follows:
- J0153 – Injection, adalimumab, 20 mg
- J3301 – Triamcinolone acetonide Injection, 10 mg
- S0155 – is used for Cardiopulmonary exercise tests with maximal oxygen uptake measurement and interpretation, per session
- S8948 – is used for the Application of modifier -25
Billing for Laser Procedures
Mistakes can be costly when billing for laser procedures, and the process can be complicated. To avoid errors, it’s essential to follow these guidelines:
- Know the Patient’s Insurance Coverage: Before performing any laser procedures, it’s crucial to know the patient’s insurance coverage. Some insurance plans may not cover certain laser treatments, while others may require pre-authorization. Knowing the patient’s coverage upfront can help you avoid costly billing mistakes.
- Document Everything: Accurate and detailed documentation is critical when billing for laser procedures. When documenting laser procedures, you should include the procedure performed, the treatment location, the number of lesions or spots treated, and any complications that occurred during the procedure.
- Code Correctly: As mentioned earlier, using the correct CPT codes is essential when billing for laser procedures. Using the wrong code or failing to use the appropriate modifiers can result in denied claims or underpayments.
- Avoid Upcoding: Upcoding is the practice of using a higher-priced code than what is necessary to increase reimbursement. This behavior is forbidden and may result in heavy fines and punishments.
- Identifying Potential Billing Errors: Even with the best practices in place, errors can still occur when billing for laser procedures. The following are some typical mistakes to avoid:
- Duplicate Billing: Billing the same service twice for the same patient is known as duplicate billing. Carefully reviewing all claims before submission can avoid this error, which can result in overpayments.
- Unbundling: When multiple CPT codes are billed separately instead of as a single code, it is known as unbundling. Using the appropriate bundled codes can avoid this error, which can result in overpayments.
- Billing for Non-Covered Services: If you bill for services not covered by the patient’s insurance plan, it can result in denied claims and underpayments. To avoid this error, it’s essential to verify the patient’s coverage before performing any laser procedures.
Avoiding Common Billing Mistakes
There are several common billing mistakes that healthcare providers should be aware of when billing for laser procedures. These mistakes can lead to claim denials or delays, which can be costly and time-consuming to resolve. Some of the most common billing mistakes include:
- Incorrect coding: Using the wrong codes for the laser procedure, or failing to include all necessary codes, can result in claim denials or delays.
- Lack of medical necessity documentation: Failing to document the medical necessity of the laser procedure can result in claim denials or delays.
- Failure to follow payer rules: Different insurance companies and government payers may have their own rules and regulations for billing for laser procedures. Failing to follow these rules can result in claim denials or delays.
By avoiding these common billing mistakes and following best practices for laser procedure billing, healthcare providers can ensure that they are maximizing their reimbursements and minimizing the risk of claim denials.
Zee Medical Billing Company is the perfect partner for healthcare providers who want to optimize their revenue cycle management. With years of experience in the industry, we provide reliable and efficient medical billing services that help our clients maximize their reimbursements and minimize their denials. Our team of certified coders and billing specialists dedicates themselves to staying up-to-date with the latest regulations and guidelines to ensure accurate and compliant billing. Whether you’re a solo practitioner or a large healthcare organization, we have the expertise and resources to streamline your billing process and improve your bottom line.
Call +1 (224) 999-6997 to make an appointment with Zee Medical Billing to discuss how they can help you with all of your cash flow challenges and payroll-related issues.
