Summary & Overview
CPT 17311: Mohs Micrographic Surgery for Skin Cancer, Complex Anatomical Sites
CPT code 17311 is a pivotal billing code for Mohs micrographic surgery, a highly specialized procedure used to treat skin cancers in sensitive and complex anatomical areas such as the head, neck, hands, feet, and genitalia. This code encompasses the comprehensive process of tumor removal, specimen mapping, color coding, and microscopic examination by the surgeon, ensuring both thorough cancer excision and tissue preservation. Mohs surgery is widely regarded as the gold standard for skin cancer treatment in these regions due to its high cure rates and minimal impact on surrounding healthy tissue.
Nationally, this code is recognized and reimbursed by major payers including Aetna, Blue Cross Blue Shield, Cigna Health, Medicare, and UnitedHealthcare. The publication provides an overview of payer coverage, clinical benchmarks, and recent policy updates relevant to Mohs micrographic surgery. Readers will gain insight into the clinical context of the procedure, typical sites of service, and the importance of accurate coding for reimbursement and compliance. The summary also highlights related codes and modifiers commonly used in conjunction with 17311, offering a comprehensive resource for stakeholders in dermatology and surgical oncology. This article serves as a key reference for understanding the scope and significance of Mohs surgery billing and policy trends across the United States.
CPT Code Overview
CPT code 17311 describes the Mohs micrographic technique, a specialized surgical procedure used in dermatology and surgical oncology for the treatment of skin cancers. This technique involves the removal of all visible tumor tissue, surgical excision of specimens, mapping and color coding of the excised tissue, and microscopic examination by the surgeon. Histopathologic preparation, including routine stains such as hematoxylin and eosin or toluidine blue, is also included. The procedure is specifically performed on the head, neck, hands, feet, genitalia, or any location where surgery directly involves muscle, cartilage, bone, tendon, major nerves, or vessels. Typical sites of service for this procedure are office settings or outpatient hospital facilities, such as Place of Service codes 11, 19, or 22. Mohs surgery is recognized for its precision in removing cancerous tissue while preserving healthy tissue, making it a critical option for complex anatomical areas.
Clinical & Coding Specifications
Clinical Context
A typical patient scenario involves an adult presenting to a dermatology clinic with a biopsy-confirmed malignant neoplasm located on the head, neck, hands, feet, genitalia, or a site where surgery may directly involve muscle, cartilage, bone, tendon, major nerves, or vessels. The patient is scheduled for Mohs micrographic surgery, which includes excision of the tumor, mapping and color coding of tissue specimens, and immediate microscopic examination by the surgeon to ensure complete tumor removal while preserving healthy tissue. The procedure is performed in an office or outpatient hospital setting, such as Place of Service 11, 19, or 22. The clinical workflow includes preoperative assessment, surgical excision, histopathologic evaluation, and possible additional stages if tumor margins are not clear.
Coding Specifications
- Modifier
59: Distinct procedural service—used when a biopsy or pathology is performed on a separate lesion on the same day as Mohs surgery. This modifier distinguishes procedures that are not normally reported together but are appropriate in certain clinical circumstances.
| Modifier Code | Description |
|---|---|
59 | Distinct procedural service—used when a biopsy or pathology is performed on a separate lesion on the same day as Mohs surgery |
Associated Provider Taxonomies: