Pathology/Lab Coding Alert

Learn exception to new NCCI edit pairs with 17311 and 17313
Bundling pathology and special stain codes with Mohs micrographic surgery is not new -- only the Mohs codes are new. But you-ll need to know when and how you can override the edit pairs if you don't want to lose payment for appropriate biopsy or stain services.

The National Correct Coding Initiative, version 13.0, took effect Jan. 1. You can access the edits online at www.cms.hhs.gov/physicians/cciedits/default.asp. Start Using New Mohs Codes CPT 2007 eliminated 17304-17310 for Mohs micrographic surgery and replaced them with the following new codes that you should be using as of Jan. 1:

- 17311 -- Mohs micrographic technique, including removal of all gross tumor, surgical excision of tissue specimens, mapping, color coding of specimens, microscopic examination of specimens by the surgeon, and histopathologic preparation including routine stain(s) (e.g., hematoxylin and eosin, toluidine blue), head, neck, hands, feet, genitalia, or any location with surgery directly involving muscle, cartilage, bone, tendon, major nerves, or vessels; first stage, up to 5 tissue blocks

- +17312 -- - each additional stage after the first stage, up to 5 tissue blocks (list separately in addition to code for primary procedure)

- 17313 -- Mohs micrographic technique, including removal of all gross tumor, surgical excision of tissue specimens, mapping, color coding of specimens, microscopic examination of specimens by the surgeon, and histopathologic preparation including routine stain(s) (e.g., hematoxylin and eosin, toluidine blue), of the trunk, arms, or legs; first stage, up to 5 tissue blocks

- +17314 -- - each additional stage after the first stage, up to 5 tissue blocks (list separately in addition to code for primary procedure)

- +17315 -- Mohs micrographic technique, including removal of all gross tumor, surgical excision of tissue specimens, mapping, color coding of specimens, microscopic examination of specimens by the surgeon, and histopathologic preparation including routine stain(s) (e.g., hematoxylin and eosin, toluidine blue), each additional block after the first 5 tissue blocks, any stage (list separately in addition to code for primary procedure). The new codes break the procedure down into two categories: for head, neck, hands, feet and genitalia; or for trunk, arms and legs. Although the old codes counted -specimens,- the new codes count -blocks,- which simply clarifies the unit of service, says Pamela J. Biffle, CPC, CCS-P, ACS-DE, director of operations for CRN Institutein Fort Worth, Texas.

The old Mohs surgery codes divided the add-on codes into second stage, third stage and each additional stage. But the new codes simply include one add-on code for each additional stage after the first, with [...]