1. jalabergeron

    Question Reconstruction Facial, MOHS RECONSTRUCTION NASAL

    I don't code plastic surgery very often and would appreciate any help with this. The flaps and grafts are quite confusing to me. The scheduling codes include 14060, 15260, 13151. Would these be correct? Any additional codes? Procedure: Reconstruction Facial, MOHS RECONSTRUCTION NASAL Pre-Op...
  2. S

    Question Re-Biopsy After 5FU

    Hello! I am trying to find guidance or articles to outline the necessity of a new biopsy for lesions previously treated with 5FU. My Providers will have patients follow-up in 3-6 months (after treating the lesion with 5FU) and then say there are malignant cells present again. Providers want...
  3. J

    Question Appropriate modifier for CPT 13122 and 17311

    Good morning everyone! I have a quick question regarding these three CPT codes. Pt came in for a MOHS procedure, as well as a complex repair afterwards. The following CPT codes were used: 13122 17312 17311 Initially, modifier 51 was used on 13122, however it was denied by UHC. Replaced it with...
  4. J

    Question: MOHS Surgery Question

    Hello everyone! I have a quick question regarding MOHS. The case is as follows: Patient came in on day xx to have staged MOHS(I-III) procedure done on him due to BCC dx. Codes 17311 and 17312 was used. However, upon further examination, provider found out that there is still residual tumor...
  5. N

    Wiki How to Code for a Non-Healing Surgical Wound without Complication/Sequela/Infection

    I have been reading the many threads on the forum regarding a non-healing/delayed-healing surgical wound, but none quite fit my situation (of note: I work in a clinic where the provider enters their codes and a coder checks them). Patient had a MOHs surgery for removal squamous cell carcinoma...
  6. N

    Question MOHs Surgery Complex Closure Add-On Code(s)

    My clinic has just added a MOHs surgeon and I have a question about the add-on codes for a complex repair. This is the pertinent info from the surgery note: Basal Cell Carcinoma, location: left forehead, MOHs 1 stage, 1 block; post-op length 3.2 cm, complex repair performed. Basal Cell...
  7. M

    Mohs, repairs, multiple code combo denials

    I'm new to Derm and I'm coming across a lot of denial issues. Examples below. Feedback appreciated! 13132-59 Claim paid 11200 Charge denied Shouldn't both claims pay seeing that the 59 was added for the NCCI edit? 17311-79 17311-79-59 (BSC left mid-jawline and BSC left lateral...
  8. M

    Complex repair 13132 rejected after billed with 17000 destruction

    I'm new to Derm. Patient had Mohs layer 17311 and the following on the same DOS. Patient had complex repair 13132, and the physician also destroyed a lesion- 17000. The Mohs and destruction paid; however, the complex repair was denied- (PTP edits for 13132 to the 17000). Is this a simple fix...
  9. K

    Wiki Mohs

    Hi - I work for a Dermatology Practice. Our Mohs surgeon performed Mohs on a patient's ear. The surgery had a total of 8 stages. I billed 17311 at 1 unit Then 17312 at 7 units I'm pretty sure only 6 units are allowed for 17312, but how do I account for the 8th stage on the claim? Please...
  10. S

    Can a porcine graft be billed with MOH's?

    Hi, Having some trouble getting 15275 (Porcine Graft) paid when done with MOh's. Is anyone having problems billing porcine grafts, or is anyone getting reimbursed for them? Under what circumstance are they being billed, or what documentation is needed to show Medical Necessity for billing one...
  11. D

    Wiki Documentation Requrements for Myocutaneous/Fasciocutaneous Flap (15732)

    Hello, I am hoping someone can help me. I work for a dermatology office that does a lot of Mohs procedures...We have a plastic surgeon that will perform the appropriate closure/repair post Mohs. Only recently some of the commercial insurances (UHC & Aetna) have been denying CPT code 15732...
  12. T

    Medicare Denial of 88305 when billed with an unrelated MOHS

    We are a dermatology practice with a doctor that specializes in MOHS (and is a histophathologist). We also employ ARNP's who will occasionally do excisions of skin cancers on the same day a MOHS is performed, which results in an 88305 charge. The pathology is read by our doctor-the...
  13. T

    Medicare Denial of 88305

    We are a dermatology office whose doctor is a certified dermatopathologist as well. He can perform MOHS. We have come across a new issue with Medicare when billing MOHS and a separate pathology on the same day. Here is an example: Patient comes in and has MOHS done on the arm by the doctor. The...
  14. K

    Wiki Bx, path and MOHs same day

    My provider is doing a biopsy/path code same day as MOHs surgery. The site is different than where the Mohs was performed. My office manager is telling me that 59 is not appropriate for the Bx and path code? I am new to this speciality and need advise. Thanks.
  15. D

    Mohs Reimbursment

    I am having trouble with Health Net Federal Services reimbursing Mohs procedures when multiple units are billed on one line. Also they are still applying modifier 51 to the first repair procedure. It's obvious their system edits are not correct and they have told me it does not matter what...