CPT code 17315 is used for billing additional blocks in Mohs micrographic surgery, ensuring accurate reimbursement for complex skin cancer treatments.
CPT code 17315 is used to describe an additional block of tissue that is processed during Mohs micrographic surgery. Mohs surgery is a precise surgical technique used to treat skin cancer. This code is specifically for each additional block of tissue beyond the first stage that the surgeon examines under a microscope to ensure all cancerous cells are removed.
For CPT code 17315, which pertains to Mohs surgery for additional blocks, the following modifiers may be applicable:
1. 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. It is often used to identify procedures that are not typically reported together but are appropriate under the circumstances.
2. Modifier 76 - Repeat Procedure by Same Physician: This modifier is used when a procedure or service is repeated by the same physician or other qualified healthcare professional subsequent to the original procedure or service.
3. Modifier 77 - Repeat Procedure by Another Physician: This modifier is used when a procedure or service is repeated by another physician or other qualified healthcare professional subsequent to the original procedure or service.
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: This modifier is used when a patient requires a return to the operating room for a related procedure during the postoperative period of the initial surgery.
5. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period: This modifier is used when an unrelated procedure or service is performed by the same physician during the postoperative period of the initial procedure.
6. Modifier 91 - Repeat Clinical Diagnostic Laboratory Test: This modifier is used for repeat laboratory tests performed on the same day to obtain subsequent (multiple) test results.
These modifiers help provide additional information about the circumstances under which the Mohs surgery for additional blocks was performed, ensuring accurate billing and reimbursement.
The CPT code 17315 is reimbursed by Medicare, but it is essential to verify the specific reimbursement details through the Medicare Physician Fee Schedule (MPFS). The MPFS provides a comprehensive list of services covered by Medicare and their respective reimbursement rates.
Additionally, it is advisable to consult with your local Medicare Administrative Contractor (MAC) for any regional variations or specific guidelines related to the reimbursement of CPT code 17315. The MACs are responsible for processing Medicare claims and can provide detailed information on coverage and payment policies.
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