Mohs Staging

Mohs Staging

August 8, 2019

Question:
My physician performed Mohs surgery on a patient with a basal cell carcinoma on his cheek. He took the first stage with 6 tissue blocks, but does cancer is still evident in the margins based on the mappings. A second stage is removed with 4 tissue blocks. The second stage shows that he completely excised the cancer. How do I code for this?

Answer:

Here is how you should code the encounter:

Stage 1:
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) (eg, 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)

Additional Tissue Block:
+17315 — each additional block after the first 5 tissue blocks, any stage (List separately in addition to code for primary procedure).

Second Stage:
+17312 — each additional stage after the first stage, up to 5 tissue blocks (List separately in addition to code for primary procedure).

No modifier is required since 17312 and 17315 are add on codes.

*This response is based on the best information available as of 08/08/19.

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