# Delayed Closure after MOHS



## armen (Mar 21, 2013)

How would you bill this kind of closure?  I'm new to Dermatology. Im thinking about closure code with 78 modifier since it required a return to OR, however I read couple of articles suggesting to use 58 since it is planned.  My problem is that Dr wants to use 79, which I think is incorrect. 
If anyone could help with some kind of written reference specific to MOHS cases that would be great, but i will appreciate any answer. Thanks!


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## mackeyjean (Mar 21, 2013)

Hi Armen,

None of the MOHS Surgery codes (17311-17315) have a global billing period.  Modifiers -58, -78, and -79 would be used if a second or related surgery was being done during a global billing period.  You should be fine billing the repair without a modifier.

Jeanette


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## armen (Mar 21, 2013)

jcansler said:


> Hi Armen,
> 
> None of the MOHS Surgery codes (17311-17315) have a global billing period.  Modifiers -58, -78, and -79 would be used if a second or related surgery was being done during a global billing period.  You should be fine billing the repair without a modifier.
> 
> Jeanette



Im sorry, I was talking about delayed closure after excision which has 10days global


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## Texascoder64 (Mar 21, 2013)

If the delayed closure was planned and the pt is in a p/o global I always use 58 mod- that 's only if it was planned this way.

If it is a bleeder (icd-9 998.11)with wound dehiscence /repair 13160 then you would  use 79 
rationale :  Complications, such as hematomas, wound dehiscence and postop bleeding are considered "unrelated" to the initial surgical procedure, since there are separate CPT codes/ICD-9 codes used for these services.

My point of reference is from Inga  Ellzey - she is a well known dermatology coding expert (reference: Complete Coder for Dermatology) I obtained my dermatology certification through her company.  

Hope this helps


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