Wiki MOHS Coding for TC vs Professional

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rrmatt41

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I'm talking with a local hospital about having my provider join them to do all of their MOHS cases. They want him to do this in their facility and they bill for the TC componet and we do the Professional.

Has anyone does this before with MOHS, or have any insights on how to go about this? Is it as simple as us putting a 26 mod and they add a TC? Any clue how much the reduction would be for billing just the professional component to Medicare?

Thanks
 
First, read the description for MOHs in your CPT book, this specifically states that the provider must act as both surgeon and pathologist, if either of these duties is delegated to another qualified health care professional then MOHs codes cannot be billed. Secondly, the PC/TC indicato under the medicare fee schedule is 0 (zero) meaning that modifiers 26 and TC cannot be used with these codes.
 
Thats what I needed to know. Do you have any suggestions on how to go about having some sort of relationship with that hospital, so they can push us these cases?

Wheather it be that we lease out our office space and split part of the cost with them, for the patients they send us. Any suggestions that would keep this opportunity alive I would greatly appreciate.

Thanks
 
My provider would be doing both the surgery and path, but the hospital was wanting to bill for the Technical,< freezing and dying of the skin, or the preparing of the slides itself. I guess since the indicator is 0, we wouldnt be able to bill this separetly meaning, the hospital bills it under my provider as do we, but for the separeate portions of the surgery is what you are saying?
 
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