Vitiligo Treatment : Know Whether to Apply 96900 or 96910

Avoid misrepresenting phototherapy services and know what dermatology codes apply

You need to examine your dermatologist's documentation to define what type of light, wavelength, and materials he used while providing phototherapy treatment to vitiligo /dychromia patients. Read this article to know what dermatology codes you should choose in such a case and how to overcome both E/M and multiequipment correct coding initiative (CCI) challenges.

In case you are charging for an office visit on the same day as phototherapy, the reimbursement might depend on the fact whether your physician's documentation includes a different diagnosis code. Experts maintain that the payers might reimburse at times if the doctor examines the patient for a different problem, hence with a different diagnosis code.

For patients having vitiligo (709.01), your dermatologist might use narrow band UVB phototherapy. The phototherapy is administered for two to three times per week for several months until the patient attains repigmentation of the skin. For this procedure, you need to pinpoint what types of phototherapy, UVA or UVB, the physician used as well as the varying wavelengths.

In case your dermatologist used tar or or petrolatum with the light treatment, you should code 96910 (Photochemotherapy; tar and ultraviolet B [Goeckerman treatment] or petrolatum and ultraviolet B). Through this procedure, the dermatologist runs ultraviolet B light, with dosages cautiously increased as the treatment develops, resulting in longer times spent under the light source.

You should report 96900 (Actinotherapy [ultraviolet light]) in case the patient applies the treatment herself.

Note: You should always check with your payer for their rules.

In case, your dermatolist prescribed psolarens combined with ultraviolet A (UVA) light therapy, you should use 96912 (Photochemotherapy; psoralens and ultraviolet A [PUVA]). If your dermatologist doesn't use tars, petrolatum or psolarens with the light treatment, the code that remains is 96900.

The difference: UVA phototherapy is generally given with a lightsensitizing tablet named psoralen (PUVA therapy). Occasionally a light-sensitizing cream or lotion having psoralen is used in localized skin areas (for instance feet [topical PUVA]). On the other hand, UVB phototherapy uses the sunburning part of the UV spectrum.

Don't take risks: If you code either 96910 or 96912 when your dermatologist uses merely a light source in the treatment or the patient applies a topical agent, you could be accused of misrepresentation of service. It could be a fraudulent claim under the Federal False Claims Act.

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