Mohs Surgery Billing And Coding

The Code Set

• 17311: head, neck, hands, feet, genitalia, or any location with surgery directly involving muscle, cartilage, bone, tendon, major nerves or vessels; first stage, up to five tissue blocks
• 17312: each additional stage at those sites, up to five tissue blocks (add-on)
• 17313: trunk, arms or legs; first stage, up to five tissue blocks
• 17314: each additional stage at those sites, up to five tissue blocks (add-on)
• 17315: each additional block beyond five, any stage (add-on)

Surgeon And Pathologist In One

The Mohs codes include both the excision and the pathology interpretation. They are reported only when the same physician performs both. Separate pathology codes such as 88305 are not billed for the Mohs sections, though a separate diagnostic biopsy on a different lesion or a frozen section to establish a diagnosis before Mohs may be reportable with documentation.

Repairs Are Separate

Closure of the Mohs defect is separately reportable: intermediate or complex repair, adjacent tissue transfer, flap or graft, chosen by the closure performed and the defect size. When repair is done on the same day, the repair code is reported in addition to the Mohs codes.

Documentation And Appropriate Use

Medicare contractors review Mohs for medical necessity against appropriate use criteria and their LCDs. The note should record the diagnosis and its pathology confirmation, the reason Mohs was indicated, the location and size, each stage with the number of blocks, and the final defect size.