CPT code 17311 is for Mohs surgery, 1 stage, on the head, neck, hands, feet, or genitalia.
CPT code 17311 is used to describe the first stage of Mohs micrographic surgery performed on the head, neck, hands, feet, or genitalia. This procedure involves the precise removal of skin cancer layer by layer, with each layer being examined under a microscope until all cancerous cells are eliminated. The code specifically applies to the initial stage of this meticulous surgical technique in these sensitive and cosmetically important areas.
For CPT code 17311, the following modifiers may be applicable:
1. Modifier 25: Significant, separately identifiable evaluation and management (E/M) service by the same physician on the same day of the procedure or other service. This modifier is used when an E/M service is provided on the same day as the Mohs surgery but is distinct and separately identifiable from the procedure.
2. Modifier 59: Distinct procedural service. This modifier is used to indicate that the Mohs surgery was distinct or independent from other services performed on the same day.
3. Modifier 76: Repeat procedure or service by the same physician or other qualified health care professional. This modifier is used if the Mohs surgery needs to be repeated on the same day by the same provider.
4. Modifier 77: Repeat procedure by another physician or other qualified health care professional. This modifier is used if the Mohs surgery is repeated on the same day by a different provider.
5. Modifier 78: Unplanned return to the operating/procedure room by the same physician following initial procedure for a related procedure during the postoperative period. This modifier is used if the patient needs to return to the operating room for a related procedure during the postoperative period of the initial Mohs surgery.
6. Modifier 79: Unrelated procedure or service by the same physician during the postoperative period. This modifier is used if an unrelated procedure is performed by the same physician during the postoperative period of the initial Mohs surgery.
7. Modifier 58: Staged or related procedure or service by the same physician during the postoperative period. This modifier is used if a staged or related procedure is planned and performed during the postoperative period of the initial Mohs surgery.
8. Modifier 22: Increased procedural services. This modifier is used if the Mohs surgery required significantly more work than typically required for the procedure.
9. Modifier 52: Reduced services. This modifier is used if the Mohs surgery was partially reduced or eliminated at the physician's discretion.
10. Modifier 53: Discontinued procedure. This modifier is used if the Mohs surgery was started but discontinued due to extenuating circumstances or those that threaten the well-being of the patient.
11. Modifier 54: Surgical care only. This modifier is used if the physician is providing only the surgical care portion of the Mohs surgery.
12. Modifier 55: Postoperative management only. This modifier is used if the physician is providing only the postoperative management of the Mohs surgery.
13. Modifier 56: Preoperative management only. This modifier is used if the physician is providing only the preoperative management of the Mohs surgery.
14. Modifier 62: Two surgeons. This modifier is used if two surgeons are required to perform the Mohs surgery together.
15. Modifier 66: Surgical team. This modifier is used if the Mohs surgery requires a surgical team due to the complexity of the procedure.
16. Modifier 80: Assistant surgeon. This modifier is used if an assistant surgeon is required during the Mohs surgery.
17. Modifier 81: Minimum assistant surgeon. This modifier is used if a minimum assistant surgeon is required during the Mohs surgery.
18. Modifier 82: Assistant surgeon (when qualified resident surgeon not available). This modifier is used if an assistant surgeon is required because a qualified resident surgeon is not available.
19. Modifier AS: Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery. This modifier is used if a physician assistant, nurse practitioner, or clinical nurse specialist assists during the Mohs surgery.
These modifiers help provide additional information about the circumstances under which the Mohs surgery was performed, ensuring accurate billing and reimbursement.
The CPT code 17311 is reimbursed by Medicare, but the reimbursement is subject to specific guidelines and conditions outlined in the Medicare Physician Fee Schedule (MPFS). The MPFS provides a comprehensive list of services covered by Medicare, along with the corresponding reimbursement rates. Additionally, Medicare Administrative Contractors (MACs) play a crucial role in determining the local coverage and payment policies for CPT code 17311. Providers should consult the MPFS and their respective MACs to ensure compliance with all Medicare requirements and to obtain accurate reimbursement information for this 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 17311. Don't let underpayments slip through the cracks—schedule a demo today and see how RevFind can optimize your revenue cycle management.
Get paid in full by bringing clarity to your revenue cycle
Subscribe to the
Healthcare Clarified newsletter
Get the latest insights on RCM and healthcare policy in your inbox
