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Official Description

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; each additional stage after the first stage, up to 5 tissue blocks (List separately in addition to code for primary procedure)

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Common Language Description

The Mohs micrographic technique, as described by CPT® Code 17314, is a specialized surgical procedure designed for the precise removal of skin cancers, particularly basal cell carcinoma and squamous cell carcinoma. This technique is unique in that it combines the roles of surgeon and pathologist, allowing for immediate examination of the excised tissue. The procedure involves the meticulous removal of cancerous skin in thin layers, which are then subjected to histopathologic preparation, including routine staining methods such as hematoxylin and eosin or toluidine blue. This staining process is crucial as it enables the surgeon to visually assess the presence of cancer cells in the removed tissue. The Mohs technique is characterized by its high success rate in completely excising tumors while preserving as much healthy tissue as possible. The surgeon employs a mapping and color-coding system for the excised specimens, which aids in tracking the tumor's removal and identifying any remaining cancerous cells. This systematic approach ensures that the excision is thorough and that the patient has the best chance of recovery with minimal scarring. CPT® Code 17314 specifically refers to the additional stages of this procedure, which occur after the initial stage, allowing for further excision of tissue blocks as needed, up to five blocks per stage. This coding structure is essential for accurate billing and documentation in the context of Mohs micrographic surgery.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

The Mohs micrographic technique is indicated for the treatment of specific types of skin cancer, particularly in cases where the tumors are complex or ill-defined. The following conditions warrant the use of this surgical method:

  • Basal Cell Carcinoma - A common form of skin cancer that arises from the basal cells in the epidermis, often characterized by slow growth and a tendency to invade surrounding tissues.
  • Squamous Cell Carcinoma - Another prevalent type of skin cancer that originates from squamous cells, which are flat cells located in the outer layer of the skin. This type can be more aggressive than basal cell carcinoma and may metastasize if not treated promptly.

2. Procedure

The Mohs micrographic technique involves several critical procedural steps to ensure the effective removal of cancerous tissue. Each step is designed to maximize the precision of the excision and minimize damage to surrounding healthy tissue:

  • Initial Tumor Excision - The surgeon begins by excising the visible tumor along with a thin layer of surrounding skin. This initial removal is crucial for obtaining a clear margin around the tumor.
  • Tissue Mapping and Color Coding - After the initial excision, the removed tissue is meticulously mapped and color-coded. This process allows the surgeon to keep track of the specific areas from which the tissue was taken, facilitating accurate identification of any remaining cancerous cells during subsequent examinations.
  • Microscopic Examination - The excised tissue is then subjected to immediate microscopic examination by the surgeon. This step is vital for determining whether cancerous cells remain in the margins of the excised tissue.
  • Additional Stages of Excision - If cancerous cells are detected, the surgeon will proceed with additional stages of excision, removing further layers of skin as necessary. Each additional stage is performed in a similar manner, with careful mapping and examination of the new tissue layers.
  • Histopathologic Preparation - Throughout the procedure, the excised specimens undergo histopathologic preparation, which includes routine staining techniques to enhance the visibility of any remaining cancer cells under the microscope.

3. Post-Procedure

After the completion of the Mohs micrographic technique, patients may experience some degree of discomfort, swelling, or bruising at the surgical site. Post-procedure care typically includes instructions for wound care to promote healing and minimize the risk of infection. Patients are advised to keep the area clean and dry, and to follow any specific guidelines provided by the surgeon regarding activity restrictions and follow-up appointments. The recovery period may vary depending on the extent of the surgery and the individual patient's healing process. Regular follow-up visits are essential to monitor the surgical site and ensure that no further cancerous cells are present.

Short Descr MOHS ADDL STAGE T/A/L
Medium Descr MOHS TRUNK/ARM/LEG EA STAGE AFTER 1ST STAGE
Long Descr 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; each additional stage after the first stage, up to 5 tissue blocks (List separately in addition to code for primary procedure)
Status Code Active Code
Global Days ZZZ - Code Related to Another Service
PC/TC Indicator (26, TC) 0 - Physician Service Code
Multiple Procedures (51) 0 - No payment adjustment rules for multiple procedures apply.
Bilateral Surgery (50) 0 - 150% payment adjustment for bilateral procedures does NOT apply.
Physician Supervisions 09 - Concept does not apply.
Assistant Surgeon (80, 82) 1 - Statutory payment restriction for assistants at surgery applies to this procedure...
Co-Surgeons (62) 0 - Co-surgeons not permitted for this procedure.
Team Surgery (66) 0 - Team surgeons not permitted for this procedure.
Diagnostic Imaging Family 99 - Concept Does Not Apply
APC Status Indicator Items and Services Packaged into APC Rates
ASC Payment Indicator Packaged service/item; no separate payment made.
Type of Service (TOS) 2 - Surgery
Berenson-Eggers TOS (BETOS) P5A - Ambulatory procedures - skin
MUE 4
CCS Clinical Classification 170 - Excision of skin lesion

This is an add-on code that must be used in conjunction with one of these primary codes.

17313 MPFS Status: Active Code APC T ASC P2 CPT Assistant Article Illustration for Code 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
17315 Addon Code MPFS Status: Active Code APC N ASC N1 CPT Assistant Article Illustration for Code 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), each additional block after the first 5 tissue blocks, any stage (List separately in addition to code for primary procedure)
88314 Addon Code MPFS Status: Active Code APC N PUB 100 CPT Assistant Article Special stain including interpretation and report; histochemical stain on frozen tissue block (List separately in addition to code for primary procedure)
79 Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.)
59 Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25.
GC This service has been performed in part by a resident under the direction of a teaching physician
76 Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service.
XS Separate structure, a service that is distinct because it was performed on a separate organ/structure
X4 Episodic/focused services: for reporting services by clinicians who provide focused care on particular types of treatment limited to a defined period and circumstance; the patient has a problem, acute or chronic, that will be treated with surgery, radiation, or some other type of generally time-limited intervention; reporting clinician service examples include but are not limited to, the orthopedic surgeon performing a knee replacement and seeing the patient through the postoperative period
Q6 Service furnished under a fee-for-time compensation arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area
XU Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service
51 Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d).
56 Preoperative management only: when 1 physician or other qualified health care professional performed the preoperative care and evaluation and another performed the surgical procedure, the preoperative component may be identified by adding modifier 56 to the usual procedure number.
58 Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78.
78 Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.)
AQ Physician providing a service in an unlisted health professional shortage area (hpsa)
CC Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed)
CR Catastrophe/disaster related
GV Attending physician not employed or paid under arrangement by the patient's hospice provider
GW Service not related to the hospice patient's terminal condition
GZ Item or service expected to be denied as not reasonable and necessary
KX Requirements specified in the medical policy have been met
LT Left side (used to identify procedures performed on the left side of the body)
Q5 Service furnished under a reciprocal billing arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area
RT Right side (used to identify procedures performed on the right side of the body)
SG Ambulatory surgical center (asc) facility service
X2 Continuous/focused services: for reporting services by clinicians whose expertise is needed for the ongoing management of a chronic disease or a condition that needs to be managed and followed with no planned endpoint to the relationship; reporting clinician service examples include but are not limited to: a rheumatologist taking care of the patient's rheumatoid arthritis longitudinally but not providing general primary care services
XE Separate encounter, a service that is distinct because it occurred during a separate encounter
XP Separate practitioner, a service that is distinct because it was performed by a different practitioner
Date
Action
Notes
2011-01-01 Changed Short description changed.
2007-01-01 Added First appearance in code book in 2007.
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