Billing and Coding: Mohs Micrographic Surgery

Mohs micrographic surgery is covered when medically necessary due to lesion complexity, size, or anatomic location and when documentation explains why standard excision/destruction is not appropriate; the surgeon typically must perform both the surgical and pathologic components. CPT codes 17311–17315 bundle surgical and surgeon-performed pathology services (do not separately report Mohs pathology), with specific rules for additional stages/blocks and limited, well-documented exceptions for separate billing (e.g., distinct lesions or rare same-day diagnostic biopsies with criteria). Detailed operative, histologic, measurement, and informed-consent documentation is required and all claim coding must follow NCCI/CPT guidance including appropriate use of modifier -59.

"Mohs micrographic surgery is covered when selected because the lesion's complexity (e."

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