Documentation requirements
Title XVIII of the Social Security Act, Section 1833(e) states that no payment shall be made to any provider of services or other person under this part unless there has been furnished such information as may be necessary in order to determine the amounts due such provider or other person under this part for the period with respect to which the amounts are being paid or for any prior period.
A Clinical Laboratory Improvement Act (CLIA) certification number is required on all claims submitted for Mohs surgery. The CLIA number should be submitted in item 23 on the CMS 1500 claim form or the electronic equivalent.
The medical record must clearly document and support the situations where modifier -59 is appropriate.
All surgical procedures performed in the same operative session should be reported on the same claim.
Codes in this policy
Code numbers and each code’s status as the policy records it. CPT code descriptions are left out of this page, as are the passages that cite CPT codes; the official document has them.
| Code | Code system | Status in this policy |
|---|---|---|
| 17311 | HCPCS | Covered |
| 17312 | HCPCS | Covered |
| 17313 | HCPCS | Covered |
| 17314 | HCPCS | Covered |
| 17315 | HCPCS | Covered |
| C00.0 | ICD10CM | Covered |
| C00.1 | ICD10CM | Covered |
| C00.3 | ICD10CM | Covered |
| C00.4 | ICD10CM | Covered |
| C00.6 | ICD10CM | Covered |
| C00.8 | ICD10CM | Covered |
| C32.0 | ICD10CM | Covered |
| C32.1 | ICD10CM | Covered |
| C32.8 | ICD10CM | Covered |