Mohs Micrographic Surgery (MMS)
L33689
Mohs micrographic surgery is covered when margins are clinically uncertain and immediate microscopic margin assessment is necessary to optimize surgical cure and reconstruction, and for specific diagnoses (eg, BCC, SCC, basalosquamous, lentigo maligna/melanoma in situ, and certain less common skin cancers) in defined anatomic areas or contexts (recurrent lesions, prior radiation, scars, chronic wounds, genetic syndromes). Coverage requires physician qualification and facility standards, and pre- or post-procedure documentation explaining why standard excision/destruction is not appropriate and justification for complex repairs; several lesion types and sizes in Area L and certain in situ/AK conditions are excluded from coverage. Verification of physician Mohs training and availability of facility/laboratory capabilities must be available for medical review.
"Mohs micrographic surgery (MMS) is indicated when the superficial (lateral) or deep margins of a cutaneous cancer are clinically uncertain and immediate microscopic examination of 100% of the surgi..."