CPT code 17314 is used for Mohs surgery, indicating an additional stage for tissue, area, or location during the procedure.
CPT code 17314 is used to describe an additional stage of Mohs micrographic surgery for the treatment of skin cancer. This code specifically applies when the surgeon needs to remove and examine more tissue beyond the initial stage to ensure all cancerous cells are eliminated. The "t/a/l" stands for tissue, additional, and layer, indicating that this code is used for each additional layer of tissue that is examined after the first stage.
Certainly! Here is a list of modifiers that could be used with CPT code 17314, along with the reasons for each:
1. Modifier 59 (Distinct Procedural Service)
- Reason: Used to indicate that a procedure or service was distinct or independent from other services performed on the same day. This is particularly useful when multiple stages of Mohs surgery are performed and need to be billed separately.
2. Modifier 76 (Repeat Procedure by Same Physician)
- Reason: Applied when the same procedure is repeated by the same physician on the same day. This can occur in Mohs surgery when additional stages are necessary.
3. Modifier 77 (Repeat Procedure by Another Physician)
- Reason: Used when the same procedure is repeated by a different physician on the same day. This might be relevant in a multi-physician practice where different doctors handle different stages.
4. Modifier 78 (Unplanned Return to the Operating/Procedure Room by the Same Physician Following Initial Procedure for a Related Procedure During the Postoperative Period)
- Reason: This modifier is used if the patient needs to return to the operating room for additional stages of Mohs surgery during the postoperative period.
5. Modifier 79 (Unrelated Procedure or Service by the Same Physician During the Postoperative Period)
- Reason: Applied when an unrelated procedure is performed by the same physician during the postoperative period of the initial procedure. This might be less common but could be relevant in complex cases.
6. Modifier 91 (Repeat Clinical Diagnostic Laboratory Test)
- Reason: Although less commonly used in Mohs surgery, this modifier can be applied if the same diagnostic test is repeated on the same day to obtain additional information.
7. Modifier 99 (Multiple Modifiers)
- Reason: Used when two or more modifiers are necessary to describe the service provided. This can be useful in complex cases where multiple stages and additional procedures are performed.
These modifiers help ensure accurate billing and reimbursement for the additional stages and complexities involved in Mohs surgery.
The CPT code 17314, which refers to an additional stage of a specific procedure, is reimbursed by Medicare. Reimbursement for this code is determined by the Medicare Physician Fee Schedule (MPFS), which outlines the payment rates for services provided to Medicare beneficiaries.
Additionally, the specific reimbursement rates and policies can vary depending on the region, as they are administered by the respective Medicare Administrative Contractor (MAC) for that area.
It is essential for healthcare providers to consult the MPFS and their local MAC to ensure accurate billing and reimbursement for CPT code 17314.
Discover how MD Clarity's RevFind software can meticulously analyze your contracts and pinpoint underpayments down to the CPT code level, including specific codes like 17314. Ensure you're receiving the full reimbursement you're entitled to from each payer. Schedule a demo today to see RevFind in action and safeguard your revenue.
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