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Moh's Reimbursement for 88342 when 88312 inconclusive

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08-28-2007, 08:30 AM

jhall1025

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Moh's Reimbursement for 88342 when 88312 inconclusive

Has anyone had any history with reimbursement using code 88342 for MOH's surgery? A question has been posed to me from a Dermatology practice where they perform MOH's surgery. If the 88312 pathology report is inconclusive to determine if the margins have been fully excised for the carcinoma, then code 88342 is being performed. The NCCI edit states that 88342 cannot be used with modifier 59, but has anyone had any luck using modifier -22 with 88342 and receiving reimbursement? Of course we do not want to anger the NCCI edit gods, but a second distinct procedure is being performed. Your assistance would be greatly appreciated!

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