One of the most common skin conditions in the United States, acne causes spots, whiteheads and pimples on the face, shoulders, back, neck, chest, and upper arms. 

Regarded as the most chronic, inflammatory skin condition, acne occurs when the hair follicles become plugged with oil and dead skin cells. The condition causes spots and pimples on visible body areas such as the face, shoulders, back, neck, chest, and upper arms. It is estimated that about 9.4 percent people worldwide have acne. According to the American Academy of Dermatology (AAD), acne is the most common skin condition in the United States. Even though acne can affect people of all ages, the condition is most common among teenagers. Treatment depends on the severity of the condition and how persistent it is. Medical billing and coding for dermatology conditions can be complex. Dermatologists treating different skin conditions need to use the right codes to report diagnosis and treatment. Errors in coding and billing can lead to late payment and denials. Partnering with a medical billing company that specializes in dermatology billing and coding can ensure accurate and timely claim submission for appropriate reimbursement. 

Depending on the severity of the condition, acne can manifest as lesions that vary in size, color and level of pain. Signs vary according to the type, such as, whiteheads (closed plugged pores), small red, tender bumps (papules), pimples (pustules), painful, pus-filled lumps under the skin (cystic lesions), large, solid, painful lumps under the skin and blackheads (open plugged pores). Excess or high production of oil (sebum) in the pore is one of the main factors that cause acne. Other causes include buildup of dead skin cells in the pore, hormonal imbalances, use of certain medications, consumption of certain foods (including carbohydrate-rich foods), and emotional stress. 

Treating Acne

The dermatologist will examine the skin to arrive identify the type of lesion. Treatment will depend on the age of the patient and the type and severity of the condition. Mild acne is usually treated with the over-the-counter (OTC) medications like gels, soaps, pads, creams, and lotions. Moderate acne may be treated with – oral antibiotics or contraceptives, topical antimicrobials, corticosteroid injections and hormone therapy (in women). Treatment modalities for severe acne that does not respond to topical or oral medications include laser and light therapy, superficial chemical peels, and surgical procedures.

Medical Codes to Report Acne

Medical coding for inflammatory skin conditions like acne can be challenging. Healthcare providers need to be familiar with the specific medical codes to report different types of acne. By outsourcing these tasks to a reputable dermatology medical billingcompany with AAPC-certified coding specialists, healthcare practices can ensure correct and timely medical billing and claims submission.

ICD-10 Codes

• L70 Acne

• L70.0 Acne vulgaris

• L70.1 Acne conglobata

• L70.2 Acne varioliformis

• L70.3 Acne tropica

• L70.4 Infantile acne

• L70.5 Acnéexcoriée

• L70.8 Other acne

• L70.9 Acne, unspecified

CPT Codes

• 10040 Acne surgery (e.g. marsupialization, opening or removal of multiple milia, comedones, cysts, pustules)

• 10060 Incision and drainage of abscess (eg, carbuncle, suppurative hidradenitis, cutaneous or subcutaneous abscess, cyst, furuncle, or paronychia); simple or single 

• 10061   Incision and drainage of abscess (eg, carbuncle, suppurative hidradenitis, cutaneous or subcutaneous abscess, cyst, furuncle, or paronychia); complicated or multiple

• 10080   Incision and drainage of pilonidal cyst; simple

• 10081   Incision and drainage of pilonidal cyst; complicated

• 10120 Incision and removal of foreign body, subcutaneous tissues, simple 

• 10121 Complicated

• 10140   Incision and drainage of hematoma, seroma or fluid collection

• 10160   Puncture aspiration of abscess, hematoma, bulla, or cyst

• 10180   Incision and drainage, complex, postoperative wound infection

• 17340 Cryotherapy (CO2 slush, liquid N2) for acne

Simple strategies to improve acne and reduce its severity include washing the face with warm water and mild soap, avoiding oil-based makeup products, removing make-up before sleeping and wearing loose clothing (if the acne is on the back, shoulders or chest).

Dermatologists and other physicians treating acne need to correctly document the diagnosis and treatment. Relying on professional dermatology medical coding services can help providers report diagnoses and treatments correctly.