Wiki Mohs Consult w/Mohs Scheduled

[Sarahp941]

I've seen this question asked several years ago, but the responses weren't as clear as I hoped. So I have a large Derm office with 15 Providers and 2 Mohs surgeons. Our Mohs surgeons want to bill an EM to evaluate the patient for Mohs, prior to having the surgery. Example: biopsy = malignant, and Mohs is a possible option. Patient is then scheduled for evaluation w/Mohs surgeon (in our Practice) and "attentively" scheduled for Mohs a week later. If Surgeon states Mohs is appropriate, then patient is already scheduled (spot held) and we bill an EM for his "consult/eval". If Mohs is not the appropriate option, then we cancel the saved spot and move forward with new treatment option and EM billed. Is this considered bundled in any way, seeing as how when we are scheduling for the Mohs "consult/eval", we are also holding a spot for surgery as well - in the event Mohs is recommended and we are not fighting for a surgery slot? Any advice is greatly appreciated! Thank you in advance!

 

[kjbeams]

No...that is not bundling. Your Mohs patients often have questions...especially about the repair and what is to be expected....medications they are taking...healing time. It makes perfect sense for the patient and surgeon to decide if slow Mohs is an option...if another specialist will do the repair depending on where the cancer is located. All of those decisions need to be coordinated and made prior to surgery. Just because you have tentatively held a spot for surgery does not mean it will happen...that is still the decision of the patient and surgeon when they meet and discuss. Some patients are fine scheduling surgery and having a quick pre-op phone call...others need to ask questions and coordinate rides and time off...especially if the defect is in an area that is noticeable and will possibly require a large incision or flap repair.