Wiki Mohs Issue - We had equipment failure

[AprilSueMadison]

On 3/13, a patient had three levels of mohs. This is coded as
17311
17312 x 2

During the third stage, we had some kind of equipment failure and had to stop the Mohs.

On 3/16, this patient came back for a continuation of the mohs.

Our billing manager sent this out as just 17312 x 3 and then sent office notes along with it. Of course it denied.

What is the correct way to code this? Is there a modifier I should use? Should this simply be...

3/13
17311
17312 x 2

3/16
17311
17312 x 2

 

[mbucknam]

Moh's Surgery

It's not entirely clear to me what you mean by a "continuation of Moh's" but if you mean that the stages did not go deep enough to be sure that all tumor was removed during the first session and additional stages were performed on a different date, I would say you are correct. Bill the base code for that date and then the add on code for each additional stage. Obviously you can never report the add on codes without reporting the base code for the same date of service.

Hope that is helpful.

 

[AprilSueMadison]

You are correct. On 3/13 after the failure, the patient was NOT clear of cancer. The procedure continued on a different date, 3/16.

So we'd just consider the first layer on 3/16 as another 17311?

 

[AprilSueMadison]

Update - since my manager is off today, I pulled the info from Medicare (she handles all Medicare, not typically me) and went through it again. For anyone else wondering:

If MOHS on a single site cannot be completed on the same day because the patient could not tolerate further surgery and the additional stages were completed the following day, you must start with the primary code (17311) on day two.