Wiki MOHS

[Elizabethfourie64@gmail.com]

I am trying to help a MOHS surgeon (I work in gen derm). He is doing MOHS on 2 or 3 separate lesions on the same day, using 17311. Do I use a 59 modifier? I'm having some claims reject even though each of the 17311 codes are linked to different diagnoses. He tells me he's used 51 modifier for years and it's "always been paid". But 51 is denying --- thank you for any help!!

 

[iowagirl77]

I am trying to help a MOHS surgeon (I work in gen derm). He is doing MOHS on 2 or 3 separate lesions on the same day, using 17311. Do I use a 59 modifier? I'm having some claims reject even though each of the 17311 codes are linked to different diagnoses. He tells me he's used 51 modifier for years and it's "always been paid". But 51 is denying --- thank you for any help!!

According to CMS, they are advising to use 59 for each separate lesion:

If a Mohs procedure is performed on a completely separate lesion on the same date of service, each first stage (CPT code 17311 or 17313) code should be reported on a separate claim line with a -59 modifier signifying a separate and distinct lesion.

https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=53883#:~:text=If%20a%20Mohs%20procedure%20is,a%20separate%20and%20distinct%20lesion.

 

[jholt12]

Hello,
I know Iowagirl has answered your question. But I bill for Mohs and I never put the modifier 51 on the charges. Like Iowagirl said it would be 17311, 17311-59, 17311-59. Also it depends on the insurance. Medicare has a LCD. So you would have to check with your state and see if there are any guidelines you should be following.