# TAllen



## kingbite (Sep 20, 2011)

I am new to dermatology and I need some help with procedure codes 17311,17312,17313,
17314 and 17315. This is my question:
Patient comes into the office we do the following Mohs surgery: head, neck,hands and feet area.
1st stage-7
2nd stage-12
3rd stage-10
4th satge-5
5th stage-6
How would you bill it? I am being told several different ways and I want to be sure that I understand the correct way to bill it.


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## JessH2618 (Sep 22, 2011)

I think a little clairification of what was done is in order.  I'm not sure what you meant by:

"1st stage-7
2nd stage-12
3rd stage-10
4th satge-5
5th stage-6"

Did your physician treat 7 lesions on the same patient?  Mohs is pretty straightforward.  Example:  A patient comes in with a BCC on the nose.  Physician does 3 stages and a 5.0 cm complex closure.  You would bill as follows:
17311
17312 x 2
13151

If you have further questions feel free to message me or post an op note.


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## kingbite (Sep 23, 2011)

*tallen*

a patient has 3 stages of Mohs performed on a lesion right forehead. 
1st stage-excised tissue cut into 10 sections
2nd stage- 14 sections were excised
3rd stage- 16 sections  were excised
tumor cells were identified on permanent sectioning and the tumor eradication was considered incomplete after a total of 3 stages of surgery in which mulitple microscopic
slides of 40 sections had been examined.

Would it be billed as follows
17311- 1 units
17312- 3 units
17315- would be billed separately 20 times with a 76 modifier


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## JessH2618 (Sep 23, 2011)

3 stages of Mohs on the forehead would be billed as follows:

17311- 1unit
17312- 2 units

Remember the 17312 is each ADDITIONAL stage after the first.  So by billing 17312 x 3, you're saying that the patient had a TOTAL of 4 stages of Mohs.  

In your example, you would bill 17315- 25 units

You said that the first stage was cut into 10 sections.  The 17311 code Includes the first 5 tissue blocks, so for the first stage you have 5 extra blocks you can bill
2nd stage was cut into 14 sections..  Again the first 5 were included, leaving you with 9 extra.  3rd stage was cut into 16 sections.  The first 5 were included, leaving you with 11.
So 5+9+11= 25


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## kingbite (Sep 26, 2011)

*JessH2618*

Thanks for your help in this .The way you stated it was the way that I had said but when you have people telling you that it is not correct you start  questioning yourself, thanks again for your help.


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