# Modifier 52?



## mmelcam (Aug 28, 2008)

My physician was called into a procedure to remove a patient's appendix. The patient was already under anesthesia and was already open for an OB procedure she was undergoing. My physician just came in the OR and removed the appendix and then left. The OB physician finished up their procedure and closed the patient. When I bill for the appendectomy, would I add a 52 modifier because we did not open or close?


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## dmaec (Aug 28, 2008)

yup...  you'd need to add add modifier .52 to the incidental appendectomy... although, incidental appendectomy during intra-abdominal surgery does not "usually" warrant a separate identification. (per guidelines in CPT manual)

_{that's my opinion on the posted matter}_


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## FTessaBartels (Aug 28, 2008)

*44955 is add-on code*

The incidental appy CPT 44955 is an add-on code. I don't see how you can  bill only this code for your surgeon (even with a -52 mod)

There also has to be some evidence of medical necessity for removal of the appendix to successfully use this code. Was it inflamed? What was the path report? 

I wonder why the OB-GYN didn't do this procedure him/herself. 

Interesting scenario - let us know how it turns out.

F Tessa Bartels, CPC


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## Lisa Bledsoe (Aug 28, 2008)

If medically necessary, what about 44950 -54?


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## crhunt78 (Aug 29, 2008)

mmelcam said:


> My physician was called into a procedure to remove a patient's appendix. The patient was already under anesthesia and was already open for an OB procedure she was undergoing. My physician just came in the OR and removed the appendix and then left. The OB physician finished up their procedure and closed the patient. When I bill for the appendectomy, would I add a 52 modifier because we did not open or close?



The CPT book states that if it is necessary to report a 44950 with another procedure, you should use a mod. 52.


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