July 7, 2015
Mohs Micrographic Surgery: Claim Submission Reminders
Our Part B Medical Review department has noticed an increase in the number of claims submitted for Mohs Micrographic Surgery (MMS) with CPT code 17311 - 17315 (performed on the trunk or extremities) that do not include documentation, as noted in the "General Information" section of the Mohs Micrographic Surgery Local Coverage Determination (LCD) L31877.
To ensure your claims are processed in the most efficient manner, please keep in mind documentation identifying one or more of the qualifying terms listed under "Indications and Limitations of Coverage" must be included. This information may be submitted either in the documentation field of your electronic claim, as an attachment to a myCGS eClaim, using the PWK segment process, or in Item 19 of your CMS-1500 claim form.
Including this documentation upon initial submission will help avoid delays in processing, as additional documentation request (ADR) letters will be sent if this information is not received.