Outpatient Facility Coding Alert

Question: I submitted a claim for 14040 and 17311 with diagnosis 173.3. Should I have applied a modifier?

Hawaii Subscriber

Answer: You don’t need to use a modifier for 14040 (Adjacent tissue transfer or rearrangement, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands, and/or feet; defect 10 sq cm or less) and the Mohs 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], head, neck, hands, feet, genitalia or any location with surgery directly involving muscle, cartilage, bone, tendon, major nerves, or vessels; first stage, up to 5 tissue blocks).

Diagnosis 173.3x (Other malignant neoplasm of skin; skin of other and unspecified parts of face) is one of several ICD-9 codes ranges which Noridian, the Medicare Part B carrier for several Western states, requires in Mohs claims. The actual list of covered ICD-9 codes, however, may vary with each carrier. You should always check with your local carrier for covered diagnoses.