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Thread: How Would You Bill This ???

  1. #1

    Question How Would You Bill This ???

    AAPC: Back to School
    Doctor #1 is a Derma/MOHS SX and he is going to remove the lesion and perforrm MOHS SX.
    He will bill CPT 99243 and CPT 17311

    Doctor #2 is a Plastic SX and he is going to come behind an do the Complex Repair
    He will bill CPT 13132

    Here is my question:

    They are both in the same practice and have the same Tax ID# and have their own NPI#.
    How would this be billed?
    All under one doctor and let them deal with the money on the back end?
    Do I bill on two seperate claims under each seperate NPI#?

    Any help would be much appreicated!
    The insurance is a medical assistance MCO.

    Thanks so much

  2. #2
    Join Date
    Apr 2007
    Milwaukee WI

    Default Two distinct specialties

    They have two distinct specialties (Dermatology and Plastic Surgery), so you would code out each surgeon's op note independently.

    NOTE ... if only ONE of them is going to do follow-up post-op care, then use the -54 modifier (surgery only) for the physician who is NOT doing the post op care.

    Hope that helps.

    F Tessa Bartels, CPC, CEMC

  3. #3


    Yes it does!

    Thanks so very much

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