Daniel M. Siegel, MD, is a clinical professor of dermatology at SUNY Downstate Health Sciences University, New York, and is the former president and honorary member of the American Academy of Dermatology (AAD).

Tips on Billing Issues in Dermatology Practices, With Daniel Siegel, MD

New rules related to billing were implemented in 2021 for determining service in outpatient interactions, and a new session presented at the 

The talk was presented at Maui Derm by Daniel M. Siegel, MD, clinical professor at SUNY Downstate Health Sciences University, and Mark Kaufman, MD, associate clinical professor in the Department of Dermatology at the Icahn School of Medicine at Mount Sinai. In a 

 with HCPLive, Siegel highlighted notable takeaways on this topic. This interview summary represents a continuation of his discussion with HCPLive.

“It's an ongoing battle, and the payers know this,” Siegel explained. “Friends from overseas will often wonder about pharma companies, the overseas companies. Somehow think that if you get in the US, you're golden…Think of the US as like the EU. Every state is a country.”

Throughout this segment of his Maui Derm interview, Siegel described reimbursement by payers as an ongoing and deliberately complex battle, describing the variation in insurance coverage and payment policies by state, by region, by insurer, and even individual plans within the same market. In a similar manner to the EU, Siegel notes insurance operates almost as though separate countries with their own rules are involved.

Such fragmentation, Siegel noted, allows payers to slow care delivery and reimbursement via administrative hurdles, including repeated phone escalations and prolonged prior authorization processes. These will commonly necessitate direct involvement by clinicians. Such tactics are embedded in the way payers manage costs and control utilization, he concluded.

“If you look at a disease like psoriasis, no one's going to argue that psoriasis is a chronic disease,” Siegel said. “But is it chronic and stable? Is it chronic and improving since the last encounter? Is it severe enough to possibly cause hospitalization?”

Pustular psoriasis, Siegel explained, can lead to cardiac failure in certain specific cases. But unless there is an ICD-10 code including acuity or comorbidities, as the diabetes codes do, then the wording in the column must be addressed. Concerning chronic diseases such as psoriasis or acne, Siegel highlighted the value of documenting whether patients have attained their treatment aims, as those who are not at their goal are, by definition, not stable and may qualify for a higher level of medical decision-making.

In this session, Siegel and Kaufman aimed their efforts at helping clinicians in dermatology navigate such challenges ethically and accurately, without leaving legitimate reimbursement unclaimed or taking any compliance violation risks. Siegel used surgical wound repair as a key example, describing the ways in which improper or templated documentation regarding complex repairs can potentially raise red flags for auditors.

Siegel additionally gave warnings to attendees, stressing the value of documentation reflecting what was actually done, as opposed to what is most advantageous for billing. Mechanisms for enforcement, Siegel noted, are more sophisticated than many comprehend.

To learn out more about this subject, view the full interview with Siegel posted above.

The quotes used in this interview summary were edited for clarity.

Siegel did not note any relevant disclosures.

Tassavor M, Shah A, Ungar J. Dermatology Resident Billing and the Impact of 2021 Evaluation and Management Coding Changes. Cureus. 2021 Jun 21;13(6):e15810. doi: 10.7759/cureus.15810. PMID: 34306877; PMCID: PMC8294024.

Siegel D, Kaufman M. How To Maximize Your Billing Effectiveness in the Era of Dwindling Reimbursements and ICD-10. Presented at the 2026 Maui Derm Hawaii Conference, January 25-29.

Videos

Siegel addressed additional points presented in his Maui Derm 2026 session, 'How To Maximize Your Billing Effectiveness in the Era of Dwindling Reimbursements and ICD-10.'

Dermatology

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Discussing Billing Challenges in Dermatology, With Daniel Siegel, MD

The effects of EMR, ICD-10, and coding changes on 

 were highlighted in a new talk presented at the 2026 Maui Derm Hawaii conference, held at the Grand Wailea Hotel in Maui from January 25 - 29.

The session was presented by Daniel M. Siegel, MD, clinical professor at SUNY Downstate Health Sciences University, and Mark Kaufman, MD, associate clinical professor in the Department of Dermatology at the Icahn School of Medicine at Mount Sinai. Siegel spoke in a new 

 interview on-site at Maui Derm about key takeaways from the talk, highlighting the process and procedures involved in ICD-10 billing.

“The biggest challenge, really, is getting paid, because payers often don't pay you, even if your documentation is well done,” Siegel explained. “...There was actually an effort in 2021 to simplify things..The effort began in about 2019, when there was a joint RUC, which stands for ‘resource-based relative value update committee,’ of the American Medical Association.”

Prior to 2021, the list of notes needed was described by Siegel as too much paperwork. While steps were taken to simplify evaluation and management (E/M) documentation beginning in 2021, insurers, and especially private payers, were described by Siegel as often failing to reimburse physicians correctly.

Such documentation shifts stemmed from a multiyear collaboration involving the American Medical Association, the CPT Editorial Panel, and the RUC. Siegel noted how, prior to these shifts, dermatologists were essentially incentivized to formulate lengthy, overly detailed notes by counting “bullet points” in reviews of systems, histories, and physical exams to excuse increased billing

Siegel later noted this practice commonly led to over-stuffed electronic medical record (EMR) notes, obscuring the clinical rationale for patient visits. Under the updated rules from 2021, clinicians did not require documentation of every possible exam element for straightforward conditions, such as well-controlled acne.

“The reality is that most acne is not the dramatic stuff you can see treated with an interesting combination of meds; it's fairly straightforward and handled well with topicals or oral tetracycline or other things,” Siegel said.

Although he notes this shift has diminished administrative burden and allowed for more practical documentation, Siegel added his belief in the system’s imperfection and inconsistency. He pointed out insurers have not uniformly adapted to these new documentation requirements, highlighting Medicare’s role in developing the updated guidelines and generally adherence to them. Many private insurers, Siegel explained, were not part of the process.

As a result of this, dermatologists may follow the current rules correctly and still see claims denied or downcoded. In such cases, Siegel expressed, the only response can often be time-consuming appeals. This disconnect between policy changes and payer behavior remains a major source of frustration and financial problems for dermatology practices

For any additional information on this topic, view the full interview with Siegel posted above.

The quotes contained in this interview were edited for clarity.

Siegel did not report any relevant disclosures.

In this interview, Siegel highlights key points presented in his Maui Derm 2026 talk, 'How To Maximize Your Billing Effectiveness in the Era of Dwindling Reimbursements and ICD-10.'

Victoria Johnson joined the MJH Life Sciences in 2020 and has written for NeurologyLive, CGTLive, and now HCPLive. You can reach her at vjohnson@mjhlifesciences.com

Welcome to HCPLive's 5 Stories in Under 5—your quick, must-know recap of the top 5 healthcare stories from the past week, all in under 5 minutes. Stay informed, stay ahead, and let’s dive into the latest updates impacting clinicians and healthcare providers like you!

Interested in a more traditional, text rundown? 

Top 5 Healthcare Headlines for January 18-24, 2025:

Phase 2 Data Show NS002 Intranasal Epinephrine Acts Faster Than EpiPen

Interim phase 2 data suggest NS002 intranasal epinephrine may provide more rapid systemic exposure than intramuscular autoinjectors, supporting its potential as a needle-free option for anaphylaxis management.

AHA 2026 Heart Disease and Stroke Statistics: Progress and Pitfalls, With Latha Palaniappan, MD, MS

The AHA’s 2026 Heart Disease and Stroke Statistics highlight persistent gaps in cardiovascular prevention and outcomes despite advances in treatment, with continued emphasis on heart disease and stroke as leading causes of mortality in the US.

New CHEST Recommendations Guide Biologic Use for Severe Asthma

CHEST released updated guidance to help clinicians individualize biologic selection for severe asthma based on patient characteristics, disease phenotype, and available evidence.

Topical Steroid Concerns in Dermatology Highlighted in Nationwide Survey

A nationwide survey underscores widespread patient and caregiver concerns about long-term topical steroid use in chronic inflammatory skin diseases and a perception that current management strategies are largely reactive rather than preventive.

Amlitelimab Effective, Safe for Atopic Dermatitis in Patients 12 Years and Older

Phase 3 data show amlitelimab was effective and well tolerated in adolescents and adults with moderate-to-severe atopic dermatitis, supporting its role as a targeted, non–T-cell-depleting biologic option.

Articles

Recent healthcare updates include promising interim phase 2 data on NS002 intranasal epinephrine, which may offer faster systemic exposure than traditional EpiPens. The AHA's 2026 statistics reveal ongoing challenges in cardiovascular prevention despite treatment advances. CHEST has issued new recommendations for biologic use in severe asthma, emphasizing personalized treatment. A survey highlights concerns over long-term topical steroid use in dermatology. Lastly, phase 3 data support amlitelimab as an effective and safe treatment for moderate-to-severe atopic dermatitis in patients aged 12 and older.

An audio recap of the top 5 stories in healthcare news from the week of 01/18-01/24.

HCPLive 5 Stories in Under 5: Week of 01/18

Henry Lim, MD, is the senior vice president of academic programs at Henry Ford Health. He previously served as chair of the department of dermatology.

Expert Consensus on Knowledge Gaps in Dermatology for Skin of Color, With Henry Lim, MD

 and clinical care for patients with skin of color have been highlighted by a recent international consensus panel, underscoring areas where underrepresentation continues to impact disease outcomes.

The authors of these data sought to point out any deficiencies across 4 major domains: skin diseases, photoprotection, hair, and aesthetic procedures. Henry Lim, MD, the former chair of dermatology and current senior vice president of academic programs at Henry Ford Health, spoke with 

 about the panel and its most significant findings.

“Well, it is a long-standing interest of mine, as well as the group of co-authors in there, and right now, we know that there is a significant gap,” Lim expressed. “So that's why we're trying to close.”

Lim and the other members of the international expert panel reviewed PubMed-indexed articles published between September 2019 - September 2024. These articles were evaluated to provide a broad overview of contemporary research trends and limitations. Inflammatory skin diseases, Lim et al found, including acne, atopic dermatitis, psoriasis, and rosacea, are common among individuals with skin of color but often present differently than in lighter skin tones.

In their research, Lim and colleagues noted pigmentary disorders such as melasma and acne-related hyperpigmentation were shown to have a notable effect on quality of life, with treatment necessitating careful selection to avoid pigmentation issues. Another notable finding was the widespread, unregulated implementation commonly seen with skin-lightening products containing potent corticosteroids, posing potentially serious safety concerns.

Lim spoke on a variety of issues the panel noted are important to consider for patients with skin of color, including conditions as common as acne.

“In dark-skinned individuals, it takes some training and some adjusting and getting used to being able to detect the redness in this group of patients,” Lim explained. “[For] post inflammatory hyperpigmentation…in dark skinned individual, it is the blemishes that are very bothersome to the patient, because they have these brown spots on the skin that may take a few years to go away.”

In his team’s work, skin cancers in skin of color were highlighted as frequently diagnosed at more advanced stages, given diminished awareness and atypical presentations.

 Additionally, the investigators noted hair disorders need tailored approaches given distinct hair characteristics.

“Skin cancer detection is very important, because otherwise it'll be a delayed diagnosis,” Lim noted. “Photoprotection, again, is something that we need to continue to emphasize…[and] there's a special tinted sunscreen which is the one that they will need to use.”

To learn more about Lim and coauthors’ findings, view the full video interview posted above.

The quotes contained in this summary were edited for clarity.

Disclosures: Lim reported investigator and research grant to institution from Incyte, L'Oreal, Pfizer, PCORI, serving as a consultant for ISDIN, Beiersdorf, Ferndale, L'Oréal, Eli Lilly, Zerigo Health, Skinosive, Kenvue, Cantabria Labs, and NAOS, and serving as a speaker at a general educational session for La Roche-Posay, Cantabria Labs, Pierre Fabre, NAOS, Uriage, Pfizer, and ISDIN.

Lim HW, Zhang C, Taylor M, Dlova NC, Conceição K, Jablonski N, Gupta N, Wangari-Olivero J, Alexis A. International Expert Consensus on Knowledge Gaps in Care for Dermatologic Disorders in Skin of Color. Int J Dermatol. 2026 Jan;65(1):41-56. 

. Epub 2025 Nov 6. PMID: 41195756; PMCID: PMC12712774.

Hogue L, Harvey VM. Basal Cell Carcinoma, Squamous Cell Carcinoma, and Cutaneous Melanoma in Skin of Color Patients. Dermatol Clin. 2019 Oct;37(4):519-526. doi: 10.1016/j.det.2019.05.009. PMID: 31466591.

This interview with Lim highlights knowledge gaps examined by an international expert panel reviewing existing literature on dermatologic disease in skin of color.

Welcome to The HCPFive, your go-to roundup for the latest healthcare news and breakthroughs, curated specifically for busy healthcare professionals.

Each week, we highlight 5 key developments or headlines from healthcare that you need to know—whether it's a cutting-edge treatment, regulatory updates, or innovations shaping the future of medicine. This week's top stories include new phase 2 data on NS002 for the treatment of 

, the publication of the 2026 Heart Disease and Stroke Statistics from the American Heart Association (AHA), new clinical guidance from the American College of Chest Physicians (CHEST) on biologic management in severe 

, findings from a national survey on topical steroid use in dermatology, and data from 2 phase 3 studies of amlitelimab for the treatment of patients ≥ 12 years of age with moderate-to-severe 

With The HCPFive, you'll get the essential takeaways to stay informed and ahead of the curve. Here’s your quick dive into the top stories for the week of January 18, 2026—let’s jump in!

On January 20, 2026, Nasus Pharma announced positive interim results from its phase 2 clinical study of NS002, the Company's investigational intranasal epinephrine powder formulation for the treatment of anaphylaxis. Results showed NS002 achieved faster absorption, higher peak concentrations, and greater early epinephrine exposure compared to intramuscular EpiPen® autoinjector.

The 2026 Heart Disease and Stroke Statistics from the AHA spotlight heart disease and stroke as being among the leading causes of death in the US, with heart disease remaining the leading cause of death and stroke moving up to the #4 spot.

CHEST released a new clinical guideline on biologic management in severe asthma, offering 7 evidence-based recommendations to provide a framework for pulmonologists, allergists, and immunologists to implement in their own practice. The document examines existing biologics and provides evidence-based recommendations for which biologics to consider for different patient populations.

ON January 21, 2026, Arcutis Biotherapeutics announced results of 

Skin Insights: Steroid Perceptions in Chronic Inflammatory Skin Diseases

, a nationwide survey of adults and parents of children with plaque psoriasis, atopic dermatitis, and seborrheic dermatitis. Results showed nearly 9 in 10 adults and parents of children with plaque psoriasis, atopic dermatitis, and seborrheic dermatitis being treated with topical steroids are concerned about side effects, and nearly 8 in 10 adults and parents agreed that their or their child's treatment plan focuses on reactively “taming a flare” rather than proactive long-term solutions. Additionally, when their skin condition is uncontrolled, nearly all adults and children experience emotional, mental, and daily life challenges

On January 23, 2026, Sanofi announced results from 2 global phase 3 studies – SHORE and COAST 2 – of amlitelimab, a fully human non-T cell depleting monoclonal antibody that selectively targets OX40-ligand, for the treatment of patients 12 years and older with moderate-to-severe atopic dermatitis. In these two phase 3 studies amlitelimab was well-tolerated and the safety profile was consistent with previously reported data.

Nasus Pharma's phase 2 study of NS002 shows faster absorption and higher peak concentrations than EpiPen for anaphylaxis treatment. The AHA's 2026 statistics highlight heart disease as the leading cause of death, with stroke now fourth. CHEST's new guidelines provide evidence-based recommendations for biologic management in severe asthma. A nationwide survey reveals significant concerns about topical steroid side effects in dermatology. Sanofi's phase 3 studies demonstrate amlitelimab's efficacy and safety for treating moderate-to-severe atopic dermatitis in patients aged 12 and older.

Stay updated with the latest healthcare breakthroughs, including new phase 2/3 data and updated asthma guidelines, in this week’s essential news roundup.

Allergy

Allergy condition center page is a comprehensive resource for clinical news and insights on allergic and inflammatory diseases. This page consists of interviews, articles, podcasts, and videos on the research, treatment and development of therapies for food and seasonal allergies, as well as allergic asthma and related conditions.

Cardiology

Cardiology condition center page is a comprehensive resource for clinical news and insights on cardiovascular and cardiometabolic diseases. This page consists of interviews, articles, podcasts, and videos on the research, treatment and development of therapies for heart disease and cardiovascular events, as well as associated diabetes, renal failure, and more...

The HCPFive: Top News for Healthcare Providers from the Week of 01/18

Mauro D'Amato, PhD, is Ikerbasque Research Professor and head of the Gastrointestinal Genetics Lab at CIC bioGUNE.

D’Amato explains his research on the biological mechanisms that control bowel movements and vitamin B1’s potential role in gut motility.

Gastroenterology

Gastroenterology condition center page is a comprehensive resource for clinical news and insights on digestive and GI conditions. This page consists of interviews, articles, podcasts, and videos on the research, treatment and development of therapies for 

, IBS and IBD, Crohn's disease, and more.

Irritable Bowel Syndrome

On the HCPLive irritable bowel syndrome page, resources on the topics of medical news and expert insight into IBS can be found. Content includes articles, interviews, videos, podcasts, and breaking news on IBS, IBD, and more.

From Physiology to Genetics: A New Lens on Gut Motility, With Mauro D’Amato, PhD

Logan Briggs is a senior urology resident at Mayo Clinic Arizona.

The first scoping review of kidney cancer pre/ rehabilitation suggests psychological support outdoes exercise and nutrition. 

Nephrology

The HCPLive nephrology page is a resource for medical news and expert insights on kidney disease. This page features expert-led coverage, articles, videos and research on the therapies and development of treatments in nephrology, and more.

 Kidney Cancer Survivors Benefit From Increased Psychological Support, With Logan Briggs, MD

Vivian Fonseca, MD, is professor of medicine, assistant dean for clinical research, and the Tullis-Tulane Alumni Chair in Diabetes at Tulane University School of Medicine.

Fonseca explains the structure and goals of the ongoing trial, which has enrolled its first patient to clofutriben treatment against hard-to-control T2D.

Endocrinology

The HCPLive endocrinology page is a comprehensive resource for clinical news and insights on endocrine system conditions. This page consists of interviews, articles, podcasts, and videos on the research, treatment and development of therapies for diabetes, hormonal disease, and more.

Type 2 Diabetes

CAPTAIN-T2D: New Trial Investigates Treating Elevated Cortisol in T2D, With Vivian Fonseca, MD

New data show heat- and pressure-treated peanuts significantly reduce IgE binding, skin test reactivity, and oral challenge severity in allergic patients.

Food Allergy

Anaphylaxis

The HCPLive anaphylaxis page is a comprehensive resource for clinical news and insights on acute allergic reactions. This page consists of interviews, articles, podcasts, and videos on the research, treatment and development of therapies for preventing anaphylaxis, and more.

Autoclaved Peanuts Reduce IgE Binding, Improve Tolerability, With Casey Cohen, PhD

Carly Maucione, MD, a resident physician at Washington University in St. Louis

Study investigator Carly Maucione, MD, discusses how artificial intelligence could support laboratory workflows while emphasizing education as a near-term solution.

Hematology

Blending Education, Machine Learning to Detect IV Fluid Contaminated CBCs, With Carly Maucione, MD

This first episode of 2026 highlights ways to advocate for change in healthcare, empowering each other and patients while navigating systemic challenges.

The Medical Sisterhood, with Mona Shahriari, MD

The Medical Sisterhood, hosted by Mona Shahriari, MD, is a podcast dedicated to empowering female physicians by providing a platform for shared experiences, mentorship, and support. 

Each episode delves into the unique challenges women in medicine face, including work-life balance, leadership roles, and overcoming gender biases. Shahriari aims to inspire women to lead fulfilling professional and personal lives on their own terms through candid discussions and expert interviews. 

e as we foster a community where women can uplift and support each other in achieving their goals!

Podcasts

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The Medical Sisterhood: Advocacy and Systemic Change, With Kristi Hawley, DO

Spyridon Fortis, MD, from the division of pulmonary, critical care, and occupational medicine at the University of Iowa Hospital and Clinics.

Fortis discusses new data that challenge the use of bronchodilator response as a tool for distinguishing asthma from COPD.

Pulmonology

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COPD

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Bronchodilator Response Predicts COPD Risk, With Spyridon Fortis, MD

Tim Smith joined the MJH Life Sciences team in 2022 and is currently an associate editor for HCPLive. He is also the executive producer of two podcasts: Skin of Color Savvy and The Medical Sisterhood. Previously, he was the producer of the Lungcast podcast. He graduated from UC Berkeley and worked in multimedia journalism as a staff writer prior to joining MJH. You can contact him at tsmith@mjhlifesciences.com.

However, key secondary endpoints, including measures of erythema, were not met in all analyses.

Atopic Dermatitis

Atopic Dermatitis condition center page, audiences can find a variety of coverage mediums for medical news and updates, including articles, video interviews, podcasts, and breaking news on dermatitis research, treatment, and drug development.

Niels Lund, MSc is the vice president of Changing Diabetes at Novo Nordisk.

Lund discusses a recent study detailing the comparatively lower greenhouse gas emissions caused by preventive care versus diabetes management.

Managing Prediabetes Lowers Carbon Footprint Compared to T2D Care, With Niels Lund, MSc

GRI-0621 shows promise as a safe, effective treatment for idiopathic pulmonary fibrosis, improving biomarkers and lung function in a Phase 2a trial.

Latest News

Tips on Billing Issues in Dermatology Practices, With Daniel Siegel, MD

Discussing Billing Challenges in Dermatology, With Daniel Siegel, MD

HCPLive 5 Stories in Under 5: Week of 01/18

Expert Consensus on Knowledge Gaps in Dermatology for Skin of Color, With Henry Lim, MD

The HCPFive: Top News for Healthcare Providers from the Week of 01/18