Wiki Mohs Question

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jdonald

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I was wondering if I could get an opinion on how cpt code 88314 is used. We are currently using it in conjuction with 17311. It is being used and the notes only say that the Tissue was processed using hematoxylin and eosin and also toluidine blue, and from that the doctor is using the 88314. I don't think this is correct.
 
Moh's

If you are reporting 17311, it would not be appropriate to report 88314 for routine stains. The notes in CPT just under 88314 state: "Do not report 88314 with 17311-17315 for routine frozen section stain...performed during Moh's surgery. When a nonroutine histochemical stain on frozen tissue is utilized, report 88314 with modifier 59.
 
We knew that much. However we are unclear on what the routine stains are. There was an article in the April coding edge that prompted these questions. It says in the article that the Mohs micrographic surgery definition states the procedure includes routine stains, such as H&E or Toluidine Blue. So if we use both of those stains can we then bill the 88314 with the mod 59?
 
Hi J. Sorry I didn't reply earlier. I forgot to look for responses in case the conversation needed to continue!

Since both stains are routine, I would say the 88314 is still inappropriate. According to the notes just above 17311 in the CPT book (page 70 in the CPT Professional edition), it states:

"Do not reoprt 88314 in conjunction with 17311-17315 for ROUTINE frozen secion stain (eg, hematoxylin and eosin, toludidine blue) performed during Mohs surgery. When a NONROUTINE histochemical stain on frozen tissue is utilized, report 88314 with modifier 59).

According to the CPT Assistant, these nonroutine, or 'special' stains would be of low frequency in most practices.

Hope this helps.
 
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