CPT code 17310 is used for Mohs surgery involving any stage with more than 5 specimens each.
CPT code 17310 is used to describe the Mohs micrographic surgery procedure when it involves more than five tissue specimens at any stage. This code is specifically for each additional specimen beyond the fifth one. Mohs surgery is a precise surgical technique used to treat skin cancer, where layers of cancer-containing skin are progressively removed and examined until only cancer-free tissue remains. This code ensures accurate billing for the complexity and extent of the procedure when multiple specimens are involved.
When using CPT code 17310, which pertains to Mohs micrographic surgery for any stage greater than five specimens, the following modifiers may be applicable:
1. Modifier 22 (Increased Procedural Services): This modifier is used when the work required to provide a service is substantially greater than typically required. For instance, if the Mohs surgery is particularly complex or time-consuming, Modifier 22 can be appended to indicate the increased effort.
2. Modifier 50 (Bilateral Procedure): If the Mohs surgery is performed on both sides of the body, Modifier 50 should be used to indicate that the procedure was bilateral.
3. Modifier 51 (Multiple Procedures): When multiple procedures are performed during the same surgical session, Modifier 51 is used to indicate that more than one procedure was carried out.
4. Modifier 59 (Distinct Procedural Service): This modifier is used to indicate that a procedure or service was distinct or independent from other services performed on the same day. For example, if another unrelated procedure is performed in conjunction with the Mohs surgery, Modifier 59 would be appropriate.
5. Modifier 76 (Repeat Procedure by Same Physician): If the Mohs surgery needs to be repeated on the same day by the same physician, Modifier 76 should be used to indicate the repeat procedure.
6. Modifier 77 (Repeat Procedure by Another Physician): If the Mohs surgery is repeated on the same day by a different physician, Modifier 77 should be used.
7. Modifier 78 (Unplanned Return to the Operating/Procedure Room by the Same Physician Following Initial Procedure for a Related Procedure During the Postoperative Period): If the patient needs to return to the operating room for a related procedure during the postoperative period, Modifier 78 should be used.
8. Modifier 79 (Unrelated Procedure or Service by the Same Physician During the Postoperative Period): If an unrelated procedure is performed by the same physician during the postoperative period of the initial Mohs surgery, Modifier 79 should be appended.
9. Modifier 99 (Multiple Modifiers): When more than four modifiers are necessary to describe the service, Modifier 99 is used to indicate that multiple modifiers are applicable.
These modifiers help provide additional information about the circumstances under which the Mohs surgery was performed, ensuring accurate billing and reimbursement.
The CPT code 17310 is reimbursed by Medicare, but the reimbursement specifics can vary. To determine if CPT code 17310 is covered and the reimbursement rate, healthcare providers should refer to the Medicare Physician Fee Schedule (MPFS). The MPFS provides detailed information on the payment rates for services covered by Medicare. Additionally, it is essential to consult the local Medicare Administrative Contractor (MAC) for any regional variations or specific guidelines that may apply. The MACs are responsible for processing Medicare claims and can provide the most accurate and up-to-date information regarding the reimbursement of CPT code 17310.
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