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17312 W/ 6 UNITS

John Posted Thu 10th of October, 2013 14:27:31 PM

The dermatologist I work for recently performed a MOHs surgery on a patient where he ended up having to go back for 6 stages, or cuts, in the patient's ear to remove all of the malignant cells. When we billed UHC for the 6 units for 17312, UHC denied 2 of the units saying "the number of units exceeds the typical frequency per day." We responded w/ an appeal which included copies of notes and photos of the surgery site to prove the medical necessity for the 6 units. Now they are saying they want a corrected claim w/ a modifier on 2 of the units to prevent further denials. What modifier should we use for this? Is it common for insurance companies to deny 17312 if more than 4 units were billed?

SuperCoder Answered Thu 10th of October, 2013 22:28:25 PM

My Editor is working on this.

Thanks,

SuperCoder Answered Thu 10th of October, 2013 22:28:25 PM
With Deb
SuperCoder Answered Fri 11th of October, 2013 15:23:14 PM

The word cut doesn't tell me enough, in Mohs there are vertical cuts going deeper and horizontal cuts going wider to code correctly I need to know which it was. The technique allows for either or but the coding could be different. Please expand on your question. Thank you.

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