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Instruction Details
Use '*' for all payers
Use '*' for all specialties
Use '*' for all states
Lower numbers have higher priority (default: 100)
Only active instructions are considered during evaluation
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Define when and how this instruction should be applied. Include criteria for evaluation and priority rules.
Critical instructions for emergency situations. This content will be prioritized during urgent cases.
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Preview
Match Criteria:
* Dermatology *
Specificity Score: 2
Higher scores indicate more specific matches
Priority: 20
Status:Active
Instructions Preview:
# Dermatology Coding Instructions

## Skin Lesion Coding
- Use appropriate CPT codes for lesion removal
- Document size, location, and method of removal
- Include pathology results when available

## Common Procedures
1. Shave Removal: CPT 11300-11313
2. Excision: CPT 11400-11471
3. Destruction: CPT 17000-17004

## Documentation Requirements
- Photograph lesions when appropriate
- Document patient consent for procedures
- Include follow-up instructions
Evaluation Rules Preview:
# Dermatology Evaluation Rules

## When to Apply This Rule
- Patient is being seen by a dermatologist
- Service involves skin-related procedures or consultations
- Provider specialty is dermatology

## Evaluation Criteria
1. Specialty Match: Confirm provider is dermatology specialist
2. Procedure Type: Verify procedure is dermatology-related
3. Documentation: Ensure proper lesion documentation
4. Consent: Verify patient consent for procedures

## Priority Application
- Apply for all dermatology services regardless of payer
- Override with payer-specific dermatology rules when available
- Use state-specific dermatology rules for higher priority
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Wildcard Usage:
  • * in any field means "all" for that criteria
  • More specific rules (fewer wildcards) take priority
  • Priority field breaks ties between equally specific rules
Examples:
  • Medicare, *, * - Applies to all Medicare cases
  • *, Dermatology, * - Applies to all dermatology cases
  • Medicare, Dermatology, California - Most specific rule