Denial driver
Wrong or unverified TennCare MCO
Why it recurs in Memphis
Multiple managed-Medicaid plans, shifting eligibility
247MBS control
Correct MCO confirmed before the encounter
Dermatology billing · Memphis, TN
Dermatology Medical Billing Services in Memphis, Tennessee
Dermatology medical billing services in Memphis from 247MBS are built for a Mid-South market with a high Medicaid share, a large TennCare managed-care book, and anchor systems at Methodist Le Bonheur, Regional One Health, and the University of Tennessee Health Science Center. Since 2005 you get a dedicated account manager, a free 360° dashboard, HIPAA plus SOC 2 Type II security, and coders who know TennCare MCO rules and the commercial and Medicare mix across the Memphis metro.
HIPAACompliant
SOC 2Type II
Serving Since2005
Specialty-FocusedRCM
We bill Dermatology for Memphis practices
Medical Dermatology
Mohs Surgery
Biopsies & Excisions
Destruction & Cryotherapy
Pathology
And More
Medical Billing for Dermatologists Across Memphis
We provide medical billing for dermatologists throughout the Memphis metro and the wider Mid-South — solo and independent dermatologists, group medical dermatology, surgical dermatology and Mohs micrographic surgeons, dermatopathology labs, pediatric dermatology, and hybrid cosmetic-plus-medical offices from Midtown, East Memphis, and Germantown to Collierville, Bartlett, and Southaven across the state line. Memphis practices see an unusually broad payer spread — commercial plans, traditional Medicare, and a heavy TennCare managed-care population served through safety-net anchors like Regional One — so the billing has to move cleanly between managed Medicaid, commercial, and Medicare rules on the same schedule. Your claims are worked by coders who understand dermatology and this market rather than treating derm as generic physician billing.
How a Dermatology Claim Gets Paid in Memphis
CPT, HCPCS, J-codes, and modifiers appear only inside the table so the prose stays plain.
| Service | Codes | What we verify first | Mid-South payer note |
|---|---|---|---|
| Same-day E&M with a procedure | 99202–99215 + modifier 25 | A distinct, separately identifiable evaluation | TennCare and commercial edits watch modifier 25 |
| Skin biopsy | 11102–11107 | Method plus per-additional-lesion add-ons | Frequency review on repeat sites |
| Excision — benign / malignant | 11400–11446 / 11600–11646 | Site, pre-excision diameter, margins; pathology before malignant final-code | Managed-Medicaid necessity documentation |
| Destruction — AK / benign / malignant | 17000 / 17003 / 17004, 17110–17111, 17260–17286 | AK counts and frequency against the coverage policy | Benign-removal necessity scrutinized |
| Mohs micrographic surgery | 17311–17315 | Stages and blocks; no separate path same specimen; modifier 58 on staged closure | Authorization on MA and some MCO plans |
| Dermatopathology | 88304 / 88305, 88312–88314 | Modifier 26 / TC split, in-house versus send-out | Sets technical-component billing |
| Biologics (buy-and-bill) | J-codes + 11900 / 11901 | Prior authorization, unit math, JW waste | Medical versus specialty-pharmacy benefit |
| Cosmetic (self-pay) | 64612 / J0585, fillers | ABN plus GA/GX/GY/GZ; collected before service | Never routed to TennCare as covered |
What Makes Dermatology Coding and Billing in Memphis Different
Memphis carries a payer mix that most Sun Belt derm markets do not. TennCare, Tennessee's Medicaid program, runs entirely through managed-care organizations — BlueCare, UnitedHealthcare Community Plan, Wellpoint, and TennCare Select — each with its own eligibility, prior-authorization, and documentation rules, and a meaningful share of the metro's dermatology patients are covered through them. TennCare covers medically necessary medical and surgical dermatology while limiting cosmetic services, so dermatology coding and billing here lives or dies on verifying the right MCO before the visit and documenting medical necessity for every destruction, biopsy, and benign removal.
Layered on top is the standard derm challenge, which Palmetto GBA administers for Tennessee's Medicare Part B claims: the same-day E&M-plus-procedure that demands a supported modifier 25, actinic keratosis destruction counts that must stay inside frequency limits, and malignant excisions that cannot be final-coded until pathology confirms. Memphis dermatologists also see genuine skin-cancer surgical volume, so Mohs staging, pre-excision measurement, and the professional-versus-technical split on dermatopathology all matter. Because a single practice may bill a TennCare MCO, a commercial plan, and Medicare in one afternoon, the discipline is switching cleanly between three rulebooks without dropping a step on any of them.
Revenue review
Put a dollar figure on what your dermatology claims are leaving behind.
A certified dermatology billing specialist reviews your coding, unit counts, authorizations and aged A/R against the payers you actually bill in Memphis, TN — and puts a number on what your current process is leaving on the table.
- Lesion counts, sizes and margins tied to the operative note
- Biopsy, destruction and excision modifiers checked against NCCI edits
- Cosmetic and non-covered services routed to patient-pay before service
HIPAA & SOC 2
Back to you within one business day
No long-term lock-in
Request a Revenue Review
Tell us about your practice.
A dermatology specialist will reach out within one business day.
Thanks — we’ve got it.
A dermatology specialist will reach out within one business day.
Where Memphis Dermatology Practices Lose Revenue
The leakage in Memphis is rarely dramatic — it is an unverified managed-Medicaid plan, an unsupported modifier, or a denial that ages out because no one worked it. We concentrate on the drivers below first.
Denial driver
Modifier 25 unsupported
Why it recurs in Memphis
Same-day E&M plus procedure on most visits
247MBS control
Note review proves a separately identifiable service
Denial driver
Medical necessity not documented
Why it recurs in Memphis
Managed Medicaid scrutinizes benign removals and destruction
247MBS control
Necessity and lesion detail captured at the visit
Denial driver
Malignant coded before pathology
Why it recurs in Memphis
Real skin-cancer surgical volume
247MBS control
Final code held until the path report confirms
Denial driver
AK destruction frequency / LCD
Why it recurs in Memphis
High actinic keratosis counts
247MBS control
Counts validated against the active coverage policy
Denial driver
Size / site / margin not documented
Why it recurs in Memphis
Excision coded without the pre-cut measurement
247MBS control
Diameter and margins captured before the specimen ships
Denial driver
Cosmetic billed as covered
Why it recurs in Memphis
Aesthetic and medical care on one schedule
247MBS control
Clean split; cosmetic collected up front with an ABN
Why Memphis Practices Outsource Dermatology Billing to 247MBS
Memphis practices lose money less to their contracts than to unverified managed-Medicaid eligibility, missing documentation, and receivables that sit unworked. When you outsource dermatology billing here to a specialty medical billing services company, the right TennCare MCO is confirmed before the visit, medical necessity is documented for every procedure, malignant excisions wait for pathology, and each denial is worked to resolution rather than written off. Our AAPC-credentialed coders handle the switch between managed Medicaid, commercial, and Medicare as daily work.
We hold ourselves to a 99% first-pass clean-claim rate, up to 40% fewer denials, 90% of worked denials recovered, days in A/R under 25, and 98% client retention, all visible on your free 360° dashboard with a dedicated account manager owning the book. See our dermatology billing services overview and our Tennessee medical billing page for the full scope, and we manage the prior authorization workload that MCOs, Medicare Advantage, and biologics create. A professional dermatology billing company built for this specialty keeps more of what a Memphis practice earns.
Choosing a Dermatology Billing Services Provider in Memphis
Dermatology billing across Tennessee
Memphis practices are billed out of the same Tennessee desk. Statewide payer detail lives on the Tennessee page.
Specialty hub
Outsource Dermatology Billing — the codes, unit rules and denials nationally, without the local layer.
Frequently Asked Questions
Yes. We verify the correct TennCare MCO before each encounter, document medical necessity to that plan's standard, and submit only covered medical and surgical dermatology, so managed-Medicaid claims are not denied for eligibility or documentation gaps.
Yes. A Memphis practice often bills all three in one day, and our coders apply the right rulebook to each claim — MCO authorization, commercial edits, or Medicare coverage policy — so nothing slips as the payer changes from patient to patient.
We run the full surgical sequence — coverage check, pre-excision measurement, pathology hold, and correct Mohs staging — on every specimen, so surgical claims move through billing cleanly rather than stalling on pathology-timing or staging errors.
Yes. We collect cosmetic services up front with an ABN and keep them entirely off TennCare, commercial, and Medicare claims, submitting only medically necessary dermatology to the payer.
lesion count·size & margins·modifier 59 / XS·cosmetic vs medical
Ready to get more Memphis claims paid on the first pass?
From solo practices to multi-provider groups, we bill Dermatology for Memphis practices with a dedicated account manager, certified coders and a live dashboard — so the units, authorizations and appeals that decide your month stop being the thing nobody has time for.
Prefer email? sales@247medicalbillingservices.com