Should the Surgeon Also Be the Pathologist for MOHS Surgery?

With modern frozen section techniques examining the edges of the specimen, the two techniques are very similar. They are both performed by fine physicians. However, I prefer to have a board certified pathologist review all pathologic specimens rather than a dermatopathologist, a dermatoligist who has trained in Moh's surgery. There are enough borderline lesions that are difficult to interpret; I prefer to have a pathologist who lives and breathes pathology rather than a dermatologist who... more

Mohs surgery by definition and to be billed as such is required to have the removal and the pathology performed  by one single and same surgeon. Anything else is not Mohs surgery. The billing is not separate for the pathology it is all bundled into the removal and examination under the microscope. You do not get a separate bill from a pathologist. My suggestion is that if you desire the advantages of Mohs surgery including a 99% cure rate then you seek out a fellowship-trained Mohs... more

By the definition, Mohs surgeon is both the pathologist reading the frozen sections prepared by Mohs technician as well as the surgeon perform the excision. Mohs micrographic surgery is the standard of care for non-melanoma skin cancers on the face and neck. The insurance reimbursement bundles both pathology and surgical services. If your 'mohs surgeon' needs a pathologist onsite, you should look for another experienced Mohs surgeon.

Hi Marcia72Q, Mohs surgery is a technique in which the dermatologist surgically removes the skin cancer and then reads the pathology. There is one fee which covers both components of this procedure. There will likely be the need for a surgical reconstruction or repair of the defect created from surgical removal of the tumor and that is typically not included in the fee for Mohs surgery. I would strongly recommend finding a fellowship trained Mohs surgeon to treat your BCC as mohs surgery... more

By it's very definition, "Mohs surgery" implies that the surgeon (dermatologist) is the same one cutting as is acting as the pathologist to interpret the frozen section margins. If you are told that you are having "Mohs surgery" yet there is a separate pathologist from the surgeon interpreting the frozen sections, then most likely you are not being treated with Mohs surgery. In that scenario, you are having "frozen sections" performed by a pathologist that... more

Dr. Krant hit the nail right on the head. Mohs Surgeons examine 100% of the tissue margin. Standard frozen section techniques typically examine less than 1%. Peer reviewed studies have shown time and time again that the cure rate with Mohs Surgery for non-melanoma skin cancer is greater than any other technique.

As most of the above answers state, Mohs micrographic surgery for skin cancer means by DEFINITION, the Mohs surgeon is also the pathologist reading slides for THAT particular skin cancer surgery case. The reason for this is that the surgeon knows best the orientation and location of the tissue, and the quality of the surrounding skin on the patient, for the best "clinicopathologic" correlation of what is under the microscope, to what is going on with the patient. A properly,... more

Dear Marcia72q, In order to be a Mohs surgeon, by definition, the surgeon must act as both the physician and the pathologist. There is one fee that covers both services. A Mohs surgeon does not have a separate fee for the pathologist. If this is the case, you are not going to a Mohs surgeon. You can find one who is fellowship-trained (a must) and approved by the Mohs College at the Mohs College website. You can search by the area in which you live. In order to be a approved by the Mohs... more

By definition, with Mohs surgery, the same treating physician functions as both the surgeon and pathologist. There should be a single charge for the entire removal of the skin cancer (including tumor excision and pathology). There would probably be a separate charge for repair of the defect following Mohs surgery. I hope this makes sense. Good luck.