MOHS SURGERY - CPT CODING |

Mohs micrographic surgery (MMS), commonly referred to as Mohs surgery, is a specialized surgical technique used to treat certain types of skin cancer. It offers the highest cure rates while minimizing the removal of healthy tissue and preserving cosmesis. Here's a guide to understanding Mohs surgery and the associated CPT coding:
Understanding Mohs Surgery:
Procedure Overview:
Mohs surgery involves the sequential removal and examination of thin layers of cancerous tissue until all cancer cells are removed.
The process allows for real-time assessment of margins, ensuring complete removal of cancer while preserving healthy tissue.
Indications:
Mohs surgery is commonly used to treat basal cell carcinoma and squamous cell carcinoma, especially in areas where tissue preservation and cosmesis are critical, such as the face.
Procedure Steps:
The surgeon removes the visible tumor along with a thin layer of surrounding tissue.
The tissue is then processed and examined under a microscope to check for cancer cells at the margins.
If cancer cells are still present, another layer of tissue is removed and examined.
This process continues until no cancer cells are detected at the margins.
Closure:
Once the cancer is completely removed, the wound may be closed using various techniques, such as primary closure, flap reconstruction, or skin grafting.
CPT Coding for Mohs Surgery:
Now, let's discuss how Mohs surgery is coded using Current Procedural Terminology (CPT) codes:
CPT Code Range:
Mohs surgery is reported using CPT codes 17311 to 17315.
Number of Tissue Layers:
The choice of CPT code depends on the number of tissue layers examined during the procedure.
Complexity of Repair:
The complexity of the repair (e.g., simple closure, complex repair, local tissue rearrangement) also influences the choice of CPT code.
Add-On Codes:
Additional procedures performed during the same encounter, such as adjacent tissue transfer or scar revision, may require appending appropriate add-on codes.
Documentation:
Accurate documentation of the number of tissue layers removed, the site of the lesion, and the closure technique used is essential for proper coding.
Example CPT Codes:
17311: Mohs micrographic technique, including removal of all gross tumor, surgical excision of tissue specimens, mapping, color coding of specimens, microscopic examination of specimens by the surgeon, and histopathologic preparation, including routine stain(s) (e.g., hematoxylin and eosin, toluidine blue), head, neck, hands, feet, genitalia, or any location with surgery directly involving muscle, cartilage, bone, tendon, major nerves, or vessels; first stage, up to 5 tissue blocks.
17312: ...second stage, up to 5 tissue blocks.
17313: ...third stage, up to 5 tissue blocks.
17314: ...each additional stage after the first, up to 5 tissue blocks (List separately in addition to code for primary procedure).
17315: Mohs micrographic technique, including removal of all gross tumor, surgical excision of tissue specimens, mapping, color coding of specimens, microscopic examination of specimens by the surgeon, and histopathologic preparation, including routine stain(s) (e.g., hematoxylin and eosin, toluidine blue), head, neck, hands, feet, genitalia, or any location with surgery directly involving muscle, cartilage, bone, tendon, major nerves, or vessels; each additional block after the first 5 tissue blocks, any stage (List separately in addition to code for primary procedure).
Conclusion:
Mohs surgery is a highly effective technique for treating certain types of skin cancer, offering excellent cure rates and cosmetic outcomes. Proper understanding of the procedure and accurate coding using CPT codes are essential for ensuring appropriate reimbursement and documentation of these procedures.
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[@gvkalyan8807]

Is this have a global period ?

[@learnwithdhanya808]

Most of the skin biopsies and Mohs codes without closures have no global period - or 0 days. However, some site-specific biopsy codes have global period of 10 days. All destruction codes have global periods of 10 days.

[@gvkalyan8807]

@@learnwithdhanya808 thank you so much sis

[@learnwithdhanya808]

@@gvkalyan8807 🙏