For lesions of the head, neck, hands, feet, and genitalia, or any location with surgery directly involving muscle, cartilage, bone, tendon, major nerves, or vessels, look to code 17311 and add-on code 17312. For lesions of the trunk, arms, and legs, select code 17313 and add-on code 17314.
CPT® 17311 in section: Mohs micrographic technique, including removal of all gross tumor, surgical excision of tissue specimens, mapping, color coding of specimens, microscopic examination of specimens by ... more.
Full
AnswerWhat does 17311 mean?
The use of CPT codes 17311-17315 is reserved for the surgeon who removes the lesion and prepares and interprets the pathology slides. The surgical pathology codes 88300-88309 and 88331-88332 and 88342 are part of the Mohs surgery and are bundled into 17311-17315.
What is Current Procedural Terminology?
Current procedural terminology (CPT) is a set of codes, descriptions, and guidelines intended to describe procedures and services performed by physicians and other health care providers. Each procedure or service is identified with a five-digit code.
What is the CPT code for billing?
CPT Codes stands for Current Procedure Terminology Codes and all these codes are used to describe medical services and procedures, tests, surgeries, etc, performed by a health professional or doctor on a patient. The list of CPT codes in medical billing is updated as per the guidance of the American Medical Association.
What is CPT number?
What is CPT ®?
- Recognizing CPT ® Codes. CPT ® codes consist of 5 characters.
- Understanding the Types of CPT ® Codes. ...
- Learning How to Use CPT ® Codes. ...
- Building Confidence with CPT ® Coding Guidelines. ...
- Appending Modifiers to CPT ® Codes. ...
- Relating CPT ® to Other Codes Sets. ...
- Establishing Medical Necessity. ...
- Preparing for a Career in Medical Coding. ...
Does CPT code 17311 require a CLIA number?
A Clinical Laboratory Improvement Act (CLIA) certification number is required on all claims submitted for Mohs surgery billed with any of the following CPT codes, 17311-17315. The CLIA number should be submitted in item 23 of the CMS 1500 claim form or the electronic equivalent.
What is a tissue block in Mohs surgery?
Thus a tissue block in Mohs surgery is defined as an individual tissue piece embedded in a mounting medium for sectioning.” ( CPT 2021, Professional Ed.
Does Medicare pay for Mohs procedure?
Mohs surgery is covered by most insurance plans, including Medicare.
How do you bill Mohs surgery?
The appropriate MOHS surgery code should be reported with the appropriate quantities for the specimens mapped in the days/units field. CPT code 17312 should be reported for additional stages with the first stage code 17311. CPT code 17314 should be reported for additional stages with the first stage code 17313.
Why is it called Mohs surgery?
Mohs Micrographic Surgery is named after its founder and originator, Frederic E. Mohs, MD (1910-2002). As a medical student from 1929 to 1934, Dr. Mohs conducted cancer research projects while working for his mentor and zoology professor, Michael Guyer.
Is Mohs a surgery?
Mohs surgery is a highly specialized technique in dermatologic surgery for treating skin cancer. The procedure is named for Frederick E. Mohs, the surgeon who developed the technique, and is also known as Mohs micrographic surgery.
What is the CPT code 17311?
CPT Code 17311 - Mohs micrographic technique, including removal of all gross tumor, surgical excision of tissue specimens, mapping, color coding of specimens, microscopic examination of specimens by the surgeon, and histopathologic preparation including routine stain(s) (e.g., hematoxylin and eosin, toluidine blue), ...
Is Mohs surgery serious?
Mohs surgery is generally considered very safe, but there are some risks: Bleeding from the site of surgery. Bleeding into the wound (hematoma) from surrounding tissue. Pain or tenderness in the area where skin was removed.
What is the difference between excision and Mohs surgery?
The Mohs process examines 100 percent of the tissue margins under the microscope, whereas in standard surgical excision only 1 percent of the margins are examined microscopically. Mohs surgery also conserves the greatest amount of healthy tissue, giving you the smallest scar possible.
Does CPT 17311 have a global period?
If the first 17311 procedure did not include a closure, the 79 would not be necessary, as there are 0 global days for that CPT code.
Can you bill an office visit with a MOHs surgery?
Can you advise? Answer: You are correct in reporting CPT code 17313 for stage 1 and 17314 for stage 2 but it is not recommended that you bill an E/M service. You already have a confirmed pathology report confirming the diagnosis and rationale for performing the MOHs surgery.
What is modifier 79 medical billing?
Modifier 79 is used to indicate that the service is an unrelated procedure that was performed by the same physician during a post-operative period. Modifier 79 is a pricing modifier and should be reported in the first position. A new post-operative period begins when the unrelated procedure is billed.
ICD-10 Equivalent of 173.11
As of October 2015, ICD-9 codes are no longer used for medical coding. Instead, use this equivalent ICD-10-CM code, which is an approximate match to ICD-9 code 173.11:
Historical Information for ICD-9 Code 173.11
Billable codes are sufficient justification for admission to an acute care hospital when used a principal diagnosis.
What must be present on any claim submitted and must be coded to the highest level of specificity?
Diagnosis(es) must be present on any claim submitted and must be coded to the highest level of specificity.
Can you report 88314 with 17311?
Do not report 88314 in conjunction with 17311-17315 for routine frozen section stain (eg, hematoxylin and eosin, toluidine blue) performed during Mohs surgery. When a non-routine histochemical stain on frozen tissue is utilized, report 88314 with modifier 59 or modifier XU-unusual, non-overlapping service.
General Information
CPT codes, descriptions and other data only are copyright 2020 American Medical Association. All Rights Reserved. Applicable FARS/HHSARS apply.
Article Guidance
Refer to the Novitas Local Coverage Determination (LCD) L34961, Mohs Micrographic Surgery (MMS), for reasonable and necessary requirements and frequency limitations. The Current Procedural Terminology (CPT)/Healthcare Common Procedure Coding System (HCPCS) code (s) may be subject to National Correct Coding Initiative (NCCI) edits.
ICD-10-CM Codes that Support Medical Necessity
It is the provider’s responsibility to select codes carried out to the highest level of specificity and selected from the ICD-10-CM code book appropriate to the year in which the service is rendered for the claim (s) submitted.
ICD-10-CM Codes that DO NOT Support Medical Necessity
All those not listed under the "ICD-10 Codes that Support Medical Necessity" section of this article.
Bill Type Codes
Contractors may specify Bill Types to help providers identify those Bill Types typically used to report this service. Absence of a Bill Type does not guarantee that the article does not apply to that Bill Type.
Revenue Codes
Contractors may specify Revenue Codes to help providers identify those Revenue Codes typically used to report this service. In most instances Revenue Codes are purely advisory. Unless specified in the article, services reported under other Revenue Codes are equally subject to this coverage determination.
What is the code for a head neck surgery?
For lesions of the head, neck, hands, feet, and genitalia, or any location with surgery directly involving muscle, cartilage, bone, tendon, major nerves, or vessels, look to code 17311 and add-on code 17312.
What is the Mohs code for frozen biopsy?
11100-59 (for the biopsy) 88331-59 (for the frozen section of the biopsy) Stains. Mohs surgery includes “routine stains,” such as hematoxylin and eosin (H&E) or toluidine blue. If the physician performs an additional, atypical stain, you may report the appropriate special stain code.
What is the exception to the CPT rule?
The exception to this rule occurs when there is “no prior pathology confirmation of a diagnosis, ” according to CPT®. In such a case, the same-day biopsy (11100 Biopsy of skin, subcutaneous tissue and/or mucous membrane (including simple closure), unless otherwise listed; single lesion, +11101 Biopsy of skin, subcutaneous tissue and/or mucous membrane (including simple closure), unless otherwise listed; each separate/additional lesion (List separately in addition to code for primary procedure) ), and frozen section pathology (88331 Pathology consultation during surgery; first tissue block, with frozen section (s), single specimen) may be reported separately, in addition to the Mohs surgery. You must append modifier 59 Distinct procedural service to the biopsy and pathology codes to confirm these procedures are not a routine part of the Mohs procedure.
Can a surgeon code multiple lesions?
If the surgeon/pathologist uses the Mohs technique on multiple lesions during the same session, code for each lesion separately.
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