Wiki Mohs

[andersont]

I am new to MOHS. A patient came in for MOHS and I billed 17311 and 17312 x 3. Patient is an elderly patient was got worn out due the initial procedure so doctor had her come back the next day to finish the procedure and coded 17312, 15260. I appended 58 modifier to the second day. Humana has paid all, but 17312 for the second day. In looking at this now, I am thinking it should have been billed as 17311. Can somebody help me, please? thanks

 

[AprilSueMadison]

I totally understand your thought process because I did the exact same thing previously with a discontinued Mohs.

Below is a direct statement Medicare sent us when we appealed our denial of the second 17312.

"If MOHS on a single site cannot be completed on the same day because the patient could not tolerate further surgery and the additional stages were completed the following day, you must start with the primary code (17311) on day two. "

 

[andersont]

In looking over the notes and talking to the doctor, I realized that's what I should have done to begin with. Would the mod 58 still be needed?

Also, where did you find the medicare statement?

 

[lanouem]

I totally understand your thought process because I did the exact same thing previously with a discontinued Mohs.

Below is a direct statement Medicare sent us when we appealed our denial of the second 17312.

"If MOHS on a single site cannot be completed on the same day because the patient could not tolerate further surgery and the additional stages were completed the following day, you must start with the primary code (17311) on day two. "

Would you have billed the 1st day mohs 17311 with a 53 modifier and then the next day bill the 17311 again with 58 modifier?