[Histonet] Billing IHC on MOHS

Carol Torrence ctorrence <@t> kmcpa.com
Wed Jun 20 11:07:12 CDT 2012

I have nothing more to add regarding this subject but would like to address concerns expressed here that touch on fairness, frequency, cost and the abilities of techs and surgeons.


This was a very rare incident involving scar tissue and tumor.  Our Mohs lab does not do immunos, our pathology lab does.  My quest was to learn more about what constitutes a block.  We stained 5 slides that were the same ‘stage’ (one block)….’to be sure there would be no ‘fall offs’. We do not want to put the patient through more waiting than necessary.   I was not trying to charge for each slide I stained or gouge the patient.  My quest was for “correct coding” not what “can” I charge.  I certified as a CPC in 2005 but do not practice in that field.  That said, I have a  good grasp as to the seriousness of the subject of coding and documentation.


I have 30 plus years of experience in histology including management.   I have always had the pleasure of working with physicians of high integrity and continue to do so in the area of dermatology.  The majority of my time has been spent in a large medical center where coding questions could be addressed ‘in house’ so to speak.  When I was consulted by the surgeon regarding coding this case, our search for the correct coding stems from the level of integrity we practice on a daily basis.  I consulted the American Society for Mohs Surgery (ASMS) as was suggested and they do not offer coding advice.  I was told that they are an administrative office and suggested that I contact AAD.


Thanks for sharing your thoughts and listening to mine.


Have a good day!  Onward and upward!

Carol M. Torrence, HT(ASCP)CM 

ctorrence <@t> kmcpa.com


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