Mohs requires the integration of an individual functioning in two separate and distinct capacities: surgeon and pathologist. If the surgeon is preforming both functions, the documentation should clearly show the surgery and the pathology that was completed by the same physician.
Some Mohs surgeons document the surgical procedure in a operative note and use Mohs Pathology note to document the histologic evaluation.
Histologic evaluation: Each stage should document the histology of the sample, if applicable:
the depth of the invasion (epidermis, dermis, fat, muscle, etc.)
cell morphology (proliferation of atypical basaloid cells, keratinocytes, inflammation, etc.)
tumor pattern (nests, cords, infiltrative, full-thickness atypia, etc.)
tumor at margins - yes or no (i.e. are the margins clear)
Based on the UHC denial, it sounds like the histologic evaluation is missing from the record or was not sent with the operative note.
As for the repair in general, you
cannot bill two separate repairs on the same site on the same date of service. Though there are a few exceptions due to complications/emergency repairs which would likely be denied then appealed with the payer.
Either the Mohs surgeon is preforming the repair OR another surgeon/physician/provider is preforming the repair. What is the derm provider documenting for their repair?