How To Use CPT Code 17313

CPT 17313 describes a specific procedure known as Mohs micrographic surgery. This surgical technique involves the removal of a malignant lesion layer by layer, along with histopathological assessment, to ensure that the margins are free from malignancy. In this article, we will explore the official description of CPT code 17313, the procedure itself, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and examples of when to use CPT 17313.

1. What is CPT Code 17313?

CPT 17313 is a code used to describe the first stage of Mohs micrographic surgery performed on the trunk, arms, or legs. During this stage, the provider applies a fixative paste, such as zinc chloride, to the area and removes a layered skin lesion. The lesion is then mapped, and the excised site is marked with ink. The provider freezes the lesion and examines it for malignancy. If malignancy is found, another layer is excised and examined. This process continues until pathology results yield a negative result for malignancy. Finally, the site is closed with sutures or a graft. CPT 17313 is used for up to five tissue blocks during this first stage procedure.

2. Official Description

The official description of CPT code 17313 is as follows: “Mohs micrographic technique, including removal of all gross tumor, surgical excision of tissue specimens, mapping, color coding of specimens, microscopic examination of specimens by the surgeon, and histopathologic preparation including routine stain(s) (eg, hematoxylin and eosin, toluidine blue), of the trunk, arms, or legs first stage, up to 5 tissue blocks.”

3. Procedure

During the first stage of Mohs micrographic surgery (CPT 17313), the provider performs the following steps:

1. Applies a fixative paste, such as zinc chloride, to the area.
2. Removes a layered skin lesion.
3. Maps the lesion, creating an individual cross-section of the malignant tissue.
4. Marks the excised site with ink.
5. Freezes the lesion and examines it for malignancy.
6. If malignancy is found, another layer is excised and examined.
7. This process continues until pathology results yield a negative result for malignancy.
8. Closes the site with sutures or a graft.

4. Qualifying circumstances

CPT 17313 is used for patients who require Mohs micrographic surgery on the trunk, arms, or legs. This procedure is typically performed for the removal of malignant lesions. The provider must perform the first stage of the surgery, which includes the removal of all gross tumor, surgical excision of tissue specimens, mapping, color coding of specimens, microscopic examination of specimens by the surgeon, and histopathologic preparation including routine stain(s) (eg, hematoxylin and eosin, toluidine blue). The code is applicable for up to five tissue blocks during this first stage.

5. When to use CPT code 17313

CPT code 17313 should be used when the provider performs the first stage of Mohs micrographic surgery on the trunk, arms, or legs. This code is specifically for up to five tissue blocks during the initial procedure. It is important to note that this code is not appropriate for subsequent stages of the surgery, which should be reported using add-on code 17314.

6. Documentation requirements

To support a claim for CPT code 17313, the provider must document the following information:

• Patient’s diagnosis and the need for Mohs micrographic surgery
• Details of the procedure performed, including the removal of all gross tumor, surgical excision of tissue specimens, mapping, color coding of specimens, microscopic examination of specimens by the surgeon, and histopathologic preparation
• Date of the procedure
• Number of tissue blocks used during the first stage
• Pathology results indicating the absence of malignancy
• Details of the closure method used
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT code 17313, ensure that the procedure meets the criteria outlined in the official description. It is important to report this code only for the first stage of Mohs micrographic surgery on the trunk, arms, or legs, and for up to five tissue blocks. For each additional stage after the first stage, use add-on code 17314. It is also crucial to follow any specific guidelines provided by the payer or insurance company regarding the use of this code.

8. Historical information

CPT code 17313 was added to the Current Procedural Terminology system on January 1, 2007. Since its addition, there have been no updates or changes to the code.

9. Similar codes to CPT 17313

While there are no similar codes to CPT code 17313, it is important to note that there is an add-on code, 17314, which should be used for each additional stage of Mohs micrographic surgery after the first stage. This code covers the same components as CPT 17313 but is reported for each additional stage, up to five tissue blocks.

9. Examples

Here are some examples of cases where CPT code 17313 would be appropriate:

1. A dermatologist performs the first stage of Mohs micrographic surgery on a patient’s leg, removing a layered skin lesion and examining it for malignancy.
2. A plastic surgeon performs the first stage of Mohs micrographic surgery on a patient’s arm, removing a malignant lesion and mapping the excised site for further examination.
3. An oncologist performs the first stage of Mohs micrographic surgery on a patient’s trunk, removing a tumor and examining it under a microscope to ensure complete excision.
4. A general surgeon performs the first stage of Mohs micrographic surgery on a patient’s leg, removing a malignant lesion and preparing the tissue specimens for histopathological examination.
5. A dermatologist performs the first stage of Mohs micrographic surgery on a patient’s arm, removing a layered skin lesion and marking the excised site for further examination.
6. A plastic surgeon performs the first stage of Mohs micrographic surgery on a patient’s trunk, removing a tumor and examining it under a microscope to ensure complete excision.
7. An oncologist performs the first stage of Mohs micrographic surgery on a patient’s leg, removing a malignant lesion and preparing the tissue specimens for histopathological examination.
8. A general surgeon performs the first stage of Mohs micrographic surgery on a patient’s arm, removing a layered skin lesion and marking the excised site for further examination.