Mohs Micrographic Surgery Utilization in the Medicare Population, 2009

Abstract

The 5% LDSSAF is highly predictive of total claim volumes and is useful for modeling practice trends. There is wide variation in MMS provider annual case volume. These data reflect only Medicare Part B enrollees in 2009; 5% LDDSAF extrapolations are predictions based on sampling.

Epidemiology of basal cell carcinoma: scholarly review

“…A recent report estimated the average annual cost of treating NMSC in the U.S.A. at $4·8 billion from 2007 to 2011, which is a 74% increase compared with the 2002–06 estimate . A relatively large part of the U.S.A. treatment costs (> $2 billion) comprise Mohs micrographic surgery (MMS), a treatment which has grown exponentially in recent decades . MMS is a cost‐effective treatment as long as it is performed by skilled physicians and used in properly selected patients, such as patients with recurrent or aggressive histological BCCs in the H‐zone (temporal, retro‐ and pre‐auricular, orbital and infranasal areas, ears and nose) .…”

Costs and Economics of Skin Cancer Management, Mohs Surgery, and Surgical Reconstruction

“…One opinion piece in the dermatology literature mentions this statistic, 2 though the article cited as this number’s source does not include this calculation. 3 Although a 7-fold increase in utilization of MMS would not in itself be problematic over this time period (MMS training only became widespread in the early 1980s and the incidence of NMSC skyrocketed), the accuracy of this statistic remains unclear.…”

Commentary on Trends in Mohs Surgery From 1995 to 2010

“…[2][3][4] Skin cancer incidence has increased by 86% in the Medicare population from 1992 to 2008 with over 3.5 million new cases of nonmelanoma skin cancer each year affecting over 2.2 million people in the United States. [3][4][5][6] In 1996, 1 in 10 skin cancers in the Medicare population was treated by Mohs surgery, increasing to 1 in 4 by 2008. [3][4][5][6] In 1996, 1 in 10 skin cancers in the Medicare population was treated by Mohs surgery, increasing to 1 in 4 by 2008.…”

“…6 Therefore, even minor under-or over-representation of physicians who perform the procedure may result in a disproportionately flawed estimation of Mohs surgery utilization by the survey. Moreover, Mohs surgery is almost exclusively used for skin cancers of the head and the neck.…”

“…6 Given that it is unlikely that Medicare and non-Medicare patients are treated under very different skin cancer treatment algorithms, assignment of the unspecified site diagnosis code favoring Mohs surgery on the trunk and extremities over head and neck must have occurred. 13% of Mohs surgeries were performed for trunk and extremity lesions.…”