PROCEDURE PLAYBOOK · DERMATOLOGY

How to appeal a Mohs Surgery denial

A Mohs denial usually isn't a rejection of the surgery itself, it's the payer bundling the repair, cutting stages, or denying the same-day biopsy or path, so a $2,000+ case gets paid at a fraction.

Common code: CPT 17311-17315 (Mohs), often with repair 13100-14302 / 15004-15261

Why it gets denied

  • The closure/repair is bundled into the Mohs code even though it's separately reportable
  • Stages beyond the first (17312/17314 add-ons) are denied or capped by units/MUE
  • The tumor location or diagnosis doesn't match the payer's Mohs-appropriate-use LCD
  • A same-day biopsy or frozen-section path is denied as included when it was distinct

What overturns it

  • Report the repair separately with the correct closure code and a distinct-procedure modifier when the closure is a separate, complex service
  • Document each stage and map units to the operative note so add-on stages are supported
  • Cite the Mohs appropriate-use criteria (AUC) and the LCD confirming the tumor type/site qualifies
  • Attach the path and op note showing the biopsy or same-day service was separately identifiable

Worth appealing? Mohs is one of the highest per-case dollar procedures a derm practice bills, so a bundled repair or a dropped stage is real four-figure money, and it's recoverable because the work is fully documented in the op note.

Common questions

How do I appeal a Mohs Surgery denial?

A Mohs denial usually isn't a rejection of the surgery itself, it's the payer bundling the repair, cutting stages, or denying the same-day biopsy or path, so a $2,000+ case gets paid at a fraction. To overturn it: report the repair separately with the correct closure code and a distinct-procedure modifier when the closure is a separate, complex service; document each stage and map units to the operative note so add-on stages are supported; cite the Mohs appropriate-use criteria (AUC) and the LCD confirming the tumor type/site qualifies; attach the path and op note showing the biopsy or same-day service was separately identifiable.

Why do Mohs Surgery claims get denied?

The closure/repair is bundled into the Mohs code even though it's separately reportable; Stages beyond the first (17312/17314 add-ons) are denied or capped by units/MUE; The tumor location or diagnosis doesn't match the payer's Mohs-appropriate-use LCD; A same-day biopsy or frozen-section path is denied as included when it was distinct.

Is a Mohs Surgery denial worth appealing?

Mohs is one of the highest per-case dollar procedures a derm practice bills, so a bundled repair or a dropped stage is real four-figure money, and it's recoverable because the work is fully documented in the op note. You pay 25% only on what's recovered, so there's no cost to working the winnable ones.

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