October 15, 2020

Question:
A Medicare patient came in last week and my doctor did a biopsy on the chest and it came back malignant and meets the Medicare criteria for MOHS surgery. The patient came in today and he performed a level 3 E/M visit and did MOHS surgery in 2 stages. I am billing 17313 for the first stage and 17314 for the second stage. My doctor also want to bill 99213 for the E/M visit. I do not think we should do that. Can you advise?

Answer:
You are correct in reporting CPT code 17313 for stage 1 and 17314 for stage 2 but it is not recommended that you bill an E/M service. You already have a confirmed pathology report confirming the diagnosis and rationale for performing the MOHs surgery. You need to ask what was the reason for performing the E/M service? Were their other problems addressed? There is an inherent E/M service as part of the pre-service evaluation for every procedure. If the only reason for the visit today is the MOHs procedure, only the procedure should be reported.

*This response is based on the best information available as of 10/15/20.