February 18, 2021

Question:
A patient was referred to our Mohs surgery for a lesion on the cheek. The family practice doctor did not do a biopsy but suspected skin cancer.  My doctor does not think we can bill for the biopsy the same day as Mohs and says it is bundled into the Mohs procedure. I do not agree.  The lesion was confirmed as BCC skin cancer. My physician performed a 2 stage Mohs procedure on the cheek and reported 17311 for the first stage and 17312 for the second stage. Can we bill for the Mohs surgery and biopsy on the same day?

Answer:
If a biopsy of a suspected skin cancer is performed on the same day as Mohs surgery because there was no prior pathology confirmation of a diagnosis, the biopsy may be separately reported along with the frozen section pathology (88331) with modifier 59 appended to each to indicate they were separate from the definitive Mohs procedure that followed.

*This response is based on the best information available as of 2/18/21.