Revised Moh's Surgery (MMS- Mohs Micrographic Surgery) Guidelines:
The mentioned below updates are effective from dates of service on and after Sept. 1, 2019.
According to CMS, Mohs surgery should only be performed by a "doctor of medicine (MD) or doctor of osteopathic medicine (DO)" who is specifically trained and highly skilled in Mohs techniques and pathologic identification
In order to maintain the quality of care and services delivered to our members, UnitedHealthcare will only reimburse Mohs surgery to an MD or DO who is specifically trained in both dermatology and pathology
If either the removal of the tumor or the pathology is delegated to another physician or other qualified health care professional, not under the same tax ID number, the Mohs code will be denied.
CMS guidance indicates that pathology examination of the tissue specimen is an inclusive component of Mohs and should not be reported separately.
Accordingly, UnitedHealthcare will deny the pathology examination, if separately reported.
Source: New Guidelines for Mohs Surgery
Blogger Widget
Popular Posts
-
Modifier - as the name implies a modifier will modify a service / procedure or an item under certain circumstances for appropriate reimbur...
-
An OPPS payment status indicator is assigned to every HCPCS code. The status indicator identifies whether the service described by the H...
-
Therapeutic activities are considered medically necessary for patients needing a broad range of rehabilitative techniques that involve ...
-
CIGNA covers chiropractic manipulation and adjunct therapeutic procedures/modalities (e.g., mobilization, therapeutic exercise, traction) ...
-
This procedure is medically necessary only when it requires the professional skills of a therapist, is designed to address specific ne...
-
Definition: The “-59” modifier is used to indicate a distinct procedural service. The physician may need to indicate that a procedure or...
-
Urgent Care Centers are the Facilities that delivers Outpatient Medical Care usually for the conditions that does not require Hospital a...
-
Modifier 51 designates multiple procedures that are rendered at the same operative session or on the same day. Modifier -51 (multiple p...
-
HCPCS Modifiers: MA Ordering professional is not required to consult a clinical decision support mechanism due to service being rend...
-
CIGNA will adopt a common time frame for health care professionals to follow for submitting claims to CIGNA. Except where state law requir...
