Wiki Mohs closure performed by PA

[Sarahp941]

I'm sure this is a silly question, but I just want to get my facts straight. How can a MD and PA bill a Mohs and closure separately and what modifier would be appended?
Basically, the MD wants to line up as many Mohs cases in a day, and knock them out, while the PA does all the closures. The closures would be billed under the PA as a separate procedure. I don't see how this could be considered an Assistant Surgeon, since the only thing the PA would be doing is just the closures. No other involvement. So using AS or 80 modifier could not be used. But I also don't see any other modifiers to append for 2 separate Providers either. I'm not sure if I am overthinking this or if this just doesn't make sense to me. Any advice is greatly appreciated. Thanks in advance!!

 

[thomas7331]

You shouldn't need any modifier for this since closures don't bundle into Mohs procedure codes. The MD is the provider of the Mohs service and the PA is the provider for the closure, so each is the surgeon for the service that they are providing - you can bill the Mohs procedure under the physician's credentials and the closure under the PA's. If it is being performed in the office and all of the 'incident to' requirements are met, it may even be possible to just bill both procedures under the physician, though I'd recommend looking into that more to confirm that your payer rules allow it.

 

[Sarahp941]

Thank you for the information! I think I was getting caught up on billing 2 Providers on the same day for procedures. And our surgery is done in office, so I will look into the "incident to" guidelines as well.