modifier for Mohs + bx + destruction premalignant

mjl903

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Local Chapter Officer
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I'm not sure where to put the modifier (if needed) in this case senario:

17311 x 2 (scalp and ear)
17000
17003
11100 - 59

I know the biopsy needs a modifer -59, what about the other two procedures?

The destruction and biopsy was done the same time as the Mohs. I don't know if the destruction and biopsy were planned to be done on a previous visit or if it was a decision made just prior to the Mohs procedure. Any suggestions?

I don't usually code for this doctor. I've requested the notes, but don't have them yet.

Thank you!
 

Susan

Expert
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463
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Chandler, AZ
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I'm not sure where to put the modifier (if needed) in this case senario:

17311 x 2 (scalp and ear)
17000
17003
11100 - 59

I know the biopsy needs a modifer -59, what about the other two procedures?

The destruction and biopsy was done the same time as the Mohs. I don't know if the destruction and biopsy were planned to be done on a previous visit or if it was a decision made just prior to the Mohs procedure. Any suggestions?

I don't usually code for this doctor. I've requested the notes, but don't have them yet.

Thank you!

I think waiting for the notes would be ideal in this situation, but with that said as long as your payer doesn't have any other policies you would only need the -59 on the biopsy. The 17000 would take a -51 and the 17003 being a add on code would not need anything. But again, please check the notes first and then with your payer before submitting.
 

mjl903

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Local Chapter Officer
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thank you! I am waiting for the notes. I'll let you know what they say!
 

mitchellde

True Blue
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Columbia, MO
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If a separate Mohs were performed for each location you do not report the 17311 with 2 units you report each one separate. This is from the Medicare guidelines for billing the Mohs procedures:
"For each additional (separate) lesion treated with Mohs surgery on the same day, bill each first stage as a 17311 or 17313 as appropriate, on a separate claim line with a -59 modifier."
If the destruction and the bx are all on separate sites you will a 59 on each one to keep them from bundling with the Mohs.
 
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