Wiki Billing for supplies in addition to Mohs procedures.

[Brandy0618]

Good morning ALL. I have utilized the "Search field" for information on being able to bill out supplies in addition to Mohs procedures. I was unable to find any threads on this subject. Can anyone tell me if you we are able to bill for supplies in addition to the Mohs procedure itself, 17311, 17313? Lidocaine injections, Tefla bandages, 4x4 blades, Coban wrap, surgical trays and sutures? Or are these supplies rolled into the procedure itself? If we can report these supplies, can anyone assist me in the correct way to do this? Thank you for any guidance offered.

 

[csperoni]

My answer is not specifically for Mohs, but rather for ANY in office procedures.
Sure, you can certainly bill for it. But don't expect payment for it.
99070 is Supplies and materials (except spectacles), provided by the physician or other qualified health care professional over and above those usually included with the office visit or other services rendered (list drugs, trays, supplies, or materials provided)
There are some HCPCs codes more specific, but are usually for DME supplies provided to the patient.
The issue you will run into is almost every carrier will bundle this along with the procedure. Codes have different RVUs whether facility vs non-facility (called site of service differential). The practice expense portion of total RVUs is to cover the cost of the additional materials and staff. For very general supplies, that differential usually does cover that. If you happen to use very specific, expensive supplies, that differential may not cover the additional cost. In which case your practice needs to make a business decision if this is a procedure you will continue to perform in office.
For 17311 for example, the practice RVU for facility is 3.66 while in office is 13.47. Translated into Medicare dollars without any location adjustment, that is $356 in facility vs $688 in office. The additional $300+ is to cover the cost of materials and staff (like RN, LPN, MA, etc to assist).
If you have carriers willing to pay for the supplies, then certainly do so. I have heard WC covers these. But on medical policies, about 1 claim per year would pay for supplies, so we just stopped even using and avoiding all the write offs.

 

[Brandy0618]

My answer is not specifically for Mohs, but rather for ANY in office procedures.
Sure, you can certainly bill for it. But don't expect payment for it.
99070 is Supplies and materials (except spectacles), provided by the physician or other qualified health care professional over and above those usually included with the office visit or other services rendered (list drugs, trays, supplies, or materials provided)
There are some HCPCs codes more specific, but are usually for DME supplies provided to the patient.
The issue you will run into is almost every carrier will bundle this along with the procedure. Codes have different RVUs whether facility vs non-facility (called site of service differential). The practice expense portion of total RVUs is to cover the cost of the additional materials and staff. For very general supplies, that differential usually does cover that. If you happen to use very specific, expensive supplies, that differential may not cover the additional cost. In which case your practice needs to make a business decision if this is a procedure you will continue to perform in office.
For 17311 for example, the practice RVU for facility is 3.66 while in office is 13.47. Translated into Medicare dollars without any location adjustment, that is $356 in facility vs $688 in office. The additional $300+ is to cover the cost of materials and staff (like RN, LPN, MA, etc to assist).
If you have carriers willing to pay for the supplies, then certainly do so. I have heard WC covers these. But on medical policies, about 1 claim per year would pay for supplies, so we just stopped even using and avoiding all the write offs.

Thank you so much for this information! It is sooo helpful and I am incredibly appreciative.