CPT CODES

CPT Code 17305

CPT code 17305 is for a two-stage Mohs surgery procedure involving up to five specimens.

Accelerate your revenue cycle

Boost patient experience and your bottom line by automating patient cost estimates, payer underpayment detection, and contract optimization in one place.

Get a Demo

What is CPT Code 17305

CPT code 17305 is used to describe a two-stage Mohs micrographic surgery procedure for the removal of skin cancer, involving up to five tissue specimens. This code is specifically for the second stage of the surgery, where additional tissue is removed and examined to ensure all cancerous cells have been excised. Mohs surgery is a precise technique that allows for the removal of cancerous tissue while sparing as much healthy tissue as possible.

Does CPT 17305 Need a Modifier?

When using CPT code 17305, which pertains to a specific medical procedure, the following modifiers may be applicable:

1. Modifier 22 - Increased Procedural Services
- Used when the work required to perform the procedure is substantially greater than typically required.

2. Modifier 50 - Bilateral Procedure
- Indicates that the procedure was performed on both sides of the body.

3. Modifier 51 - Multiple Procedures
- Used when multiple procedures are performed during the same session.

4. Modifier 58 - Staged or Related Procedure or Service by the Same Physician or Other Qualified Health Care Professional During the Postoperative Period
- Indicates that the procedure was planned or anticipated at the time of the original procedure.

5. Modifier 59 - Distinct Procedural Service
- Used to identify procedures/services that are not normally reported together but are appropriate under the circumstances.

6. Modifier 76 - Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional
- Indicates that a procedure or service was repeated by the same provider.

7. Modifier 77 - Repeat Procedure by Another Physician or Other Qualified Health Care Professional
- Indicates that a procedure or service was repeated by a different provider.

8. Modifier 78 - Unplanned Return to the Operating/Procedure Room by the Same Physician or Other Qualified Health Care Professional Following Initial Procedure for a Related Procedure During the Postoperative Period
- Used when a related procedure is performed during the postoperative period of the initial procedure.

9. Modifier 79 - Unrelated Procedure or Service by the Same Physician or Other Qualified Health Care Professional During the Postoperative Period
- Indicates that an unrelated procedure was performed by the same provider during the postoperative period.

10. Modifier 91 - Repeat Clinical Diagnostic Laboratory Test
- Used when the same laboratory test is repeated on the same day to obtain subsequent (multiple) test results.

These modifiers help provide additional information about the circumstances under which the procedure was performed, ensuring accurate billing and reimbursement.

CPT Code 17305 Medicare Reimbursement

The CPT code 17305, which involves a specific medical procedure, is subject to reimbursement by Medicare. To determine if this particular CPT code is reimbursed, healthcare providers should refer to the Medicare Physician Fee Schedule (MPFS). The MPFS provides detailed information on the reimbursement rates for various CPT codes, including 17305. Additionally, it is essential to consult with the relevant Medicare Administrative Contractor (MAC) for your region, as they administer Medicare claims and can provide specific guidance on coverage and reimbursement policies for CPT code 17305. Each MAC may have slightly different interpretations and requirements, so verifying with them ensures compliance and accurate reimbursement.

Are You Being Underpaid for 17305 CPT Code?

Discover the power of MD Clarity's RevFind software to ensure you're getting paid what you deserve. With RevFind, you can effortlessly read your contracts and detect underpayments down to the CPT code level, including specific codes like 17305. Schedule a demo today to see how RevFind can help you identify and address underpayments by individual payer, maximizing your revenue and streamlining your financial operations.

Get paid in full by bringing clarity to your revenue cycle

Full Page Background