Yes, immediate repair is done after the procedure. The dermabrasion is coming into play usually about 6-8 weeks after the MOHS procedure if there is still bleeding occurring and suture granuloma is notated. It is not done on all MOHS patients, only ones where the wound is not properly healing, which we know can sometimes occur. My argument is that this isn't necessarily cosmetic, because it is due to the MOHS surgery that the patient is having to have this performed and since we sometimes know this to be the case a modifier 58 would help us show it is non-cosmetic. What my doctor worries about is using the original malignant code again as the primary code since technically the cancer is gone but, I have been told Z codes should not be used as primary, perhaps we should try L92.3 (Foreign body granuloma) - but that doesn't tie it to the original MOHS surgery which I think we should have a code in there that does.