Wiki Bx, path and MOHs same day

[kristinemarie]

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.

 

[thomas7331]

The only alternative to a 59 modifier in this situation would be one of the new X- modifiers - I would probably use XS since I would consider the different lesion to be a separate structure. But modifier 59 is still valid. Why does your manager consider this inappropriate? Without a modifier the biopsy and path will bundle with the Mohs charge and you won't be reimbursed.

 

[TrinaJKGarcia]

59 or XS is appropriate, but since ICD-10 has been implemented, Medicare is denying our 88305 even though it is on a separate lesion than the MOHS was performed on.....any info on this??

 

[kristinemarie]

More info found

59 or XS is appropriate, but since ICD-10 has been implemented, Medicare is denying our 88305 even though it is on a separate lesion than the MOHS was performed on.....any info on this??

I have found an LCD Article with Cahaba and the will not allow a path charge same day as a MOHS for any reason. This article LCD A52811, also says it is not appropriate to provider any other exc/surgical procedure (other body area) the same day as MOHS. We are getting denials left and right for this. My manager, who is not a coder says, that just because the LCD says it's not appropriate, that doesn't mean they won't pay. Any advise on this for me?