I was just diagnozed with BCC and MOHS Surgery has been recommended. I am a self pay patient and the Dematologist stated that there will be a separate fee for the pathologist who has to be onsite. Is this normal or should I insist on a Surgeon who also acts as the pathologist? What kind of fees are usually associated with this procedure?
January 23, 2011
Answer: The Mohs Surgeon is the Pathologist
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 surgeon to perform your surgery. The entire procedure from start to finish inclduing removal, microscopic examination and reconstruction is perfomed by the same person. Frozen section is not the same as Mohs surgery in anyway shape or form except for the fact that the tissue is frozen immediately for examination. The processing of the tissue is completely different in almost all cases where Mohs examines 100% of the margins in a horizontal fashion while "frozen section" looks at less than 1% of the margins in a vertical breadloafing manner. That being said, whether you are paying out of your pocket or your insurance is paying for your care you need to be sure you are getting what you are paying for.
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January 23, 2011
Answer: The Mohs Surgeon is the Pathologist
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 surgeon to perform your surgery. The entire procedure from start to finish inclduing removal, microscopic examination and reconstruction is perfomed by the same person. Frozen section is not the same as Mohs surgery in anyway shape or form except for the fact that the tissue is frozen immediately for examination. The processing of the tissue is completely different in almost all cases where Mohs examines 100% of the margins in a horizontal fashion while "frozen section" looks at less than 1% of the margins in a vertical breadloafing manner. That being said, whether you are paying out of your pocket or your insurance is paying for your care you need to be sure you are getting what you are paying for.
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December 20, 2009
Answer: The Mohs Surgeon is the pathologist and the surgeon 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 are most likely oriented vertically versus horizontally (typically Mohs sections).
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December 20, 2009
Answer: The Mohs Surgeon is the pathologist and the surgeon 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 are most likely oriented vertically versus horizontally (typically Mohs sections).
Helpful