Policyholder Services

Is Mohs reconstruction surgery covered?

Yes. Mohs reconstruction surgery is considered within the ordinary and customary scope of practice of an oculofacial plastic surgeon and is automatically included under OMIC’s Surgery Class 3 coverage classification. Commonly performed to repair wounds following removal of skin cancer, Mohs reconstruction surgery may be performed on the eyelid, forehead, cheek, nose, lips, scalp, or virtually any place on the face.

Unlike Mohs reconstruction surgery, Mohs surgery is performed by specially trained dermatologists.  Also known as chemosurgery, Mohs surgery is a complex, microscopically controlled surgery used to treat skin cancer. Tissue is surgically removed, mapped and color-coded, and thoroughly examined under a microscope for cancer cells while the patient waits. All of the tissue margins are carefully evaluated during the surgery to ensure that the entire tumor has been removed before reconstruction occurs. Surgeons who perform Mohs surgery must be highly skilled in all aspects of this technique, including surgical removal of the tumor, pathologic examination of the tissue, and advanced reconstruction techniques of the skin, and they must have appropriately trained lab staff and technicians to assist with cutting and preparing the specimens. Due to the high liability exposure associated with failure to treat cancer, OMIC is not in a position to offer coverage for Mohs surgery but is able to offer coverage for the repair of the Mohs defect after clearance by the Mohs surgeon.

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