TrinaJKGarcia
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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 histopathologist--who is also the one who would have performed the MOHS. We have avoided denials in the past by placing a 59 modifier on the 88305 to indicated it was for a separate procedure. Medicare is now denying the 88305 and have afforded no appeal rights. Has anyone else encountered this and have a solution? Medicare tells us that this is a new edit and they do not have a publication out yet. Is it appropriate to bill the 88305 on the day he reads the slide instead of the day of the biopsy? We did try to bill it using the XS modifier for Medicare instead of the 59 today, so we will find out of that is the trick soon! Any help would be appreciated!