Dermatology coding

I have a provider who saw a pt for an office visit and also did acne surgery (10040) and destruction (17000). The diagnosis list I received was 702.11/706.1/692.74/216.1. Does anyone know how to code this so Medicare will pay. Please help! Thanks

Just link them

You can bill the E&M (perhaps a level 3) with -25 linked to the diagnoses that required eval and mgmt time, so perhaps acne would fit there. Documentation must show work done besides "Pt has acne- will do surgery," perhaps including developing a careplan, recommending skin products, prescribing medications. For the keratoses, in general the eval and mgmt service is bundled into the surgery fee since it is a simple evaluation.