Mohs micrographic surgery CPT coding guidelines by bharath kumar medesun student

1. MOHS MICROGRAPHIC SURGERY

2.  This tecnique is different from excision
 Main aim of this technique is 100% result
(or)complete removal of lesion
 Here dual role is performed by the physician
a) Surgeon
b) Pathologist

4. PROCEDURE
 various stages are involved in this process for
complete removal of lesions
 Removed tissue is divided as blocks/pieces
 Each block examined for evalution
 Every stage contain minimum 5 blocks(default)
 For addition of each extra block code may vary

5.  Any repair is performed code separately
 Any biopsy is performed on same day along with
mohs surgery code separately with modifier 59.
 (17315)code for each additional block in addition to
code for primary procedure.

6.  MEDICAL TERMINOLOGY
CRYOTHERAPY:-also called as cold therapy
 it is a procedure used to destroy the benign or
malignant lesions using low temperature(co2slush,
liquid N2).

7.  It is a modified sweat gland
 breasts are made of specialized tissue that
produces milk (glandular tissue) as well as fatty
tissue. The amount of fat determines the size of the
breast.
 Breast cancer is most common in females

8.  MASTOTOMY: incision of the breast
 FISTULA: abnormal connection between to hallow
spaces
 GYNACOMASTIA: enlargement of male breast due
to endocrine disorders
 GALACTOGRAPHY or DUCTOGRAPHY (or galact
ogram, ductogram) is a medical diagnostic
procedure for viewing the milk ducts.

9. BREAST SURGERY PROCEDURES
 INCISION
 Making a small cut and allow to drain the cyst of
breast.
 Range of code(19000-19030).

10.  EXCISION:-
removal of cysts benign and malignant tumers
breast biopsies without image guidance are reported
with 19100-19101.
Image guided breast biopsies with placement of
localization devices are reported with 19081-19086.

11.  Placement of localization devices without image-
guided biopsy are reported with 19281-19288.
 Partial mastectomy procedures are reported using
codes 19301 or 19302.
 Total mastectomy procedures are reported using
codes 19303-19307 as appropriate.

12.  STEREOTACTIC BIOPSY
 it is also known as stereotactic core biopsy
 this procedure uses a computer and imaging
performed in at least two planes to localize a target
lesion.
This technique is very useful in identifying micro
calcifications

13.  REPAIR/RECONSTRUCTION
In this procedure breast is repaired to function as
normal.
AUGUMENTATION: increasing size of the breast
using some localization devices
MASTOPEXY: surgical fixation(or) re-positioning of
breast
RANGE OF CODE:19316-19396
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