# Multiple Lumbar Punctures with NO fluid obtained



## renifejn (Apr 22, 2009)

A physician tried 3 times to obtain fluid from the patient during the lumbar puncture, but each time was unsuccessful.

"Under sterile conditions, spinal needle inserted into L4-L5 space, unable to get fluid. Returned with new needle and again unsuccessful. Pt repositioned and third attempt made with new needle and again unsuccessful"

How would you code this if at all?

http://www.info-x-inc.com/templates/third_level_docs.asp?docid=575

I found this but it doesnt tell me exactly what I'm looking for


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## RebeccaWoodward* (Apr 22, 2009)

Have you looked at 62270?...Attaching modifier 53


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## renifejn (Apr 22, 2009)

Wasnt sure if we add mod -53?  -53?  or code it 3 times using the -76/77??


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## RebeccaWoodward* (Apr 22, 2009)

77 wouldn't apply since it's the same physician (assuming)

I don't know that the carrier will pay for three attempts but you never know...

62270-53
62270-76/53
62270-76/53

Anyone else?


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## Dooley (Jul 31, 2009)

*How did that work?*

I was wondering how you ended up billing these three LPs (and if they were accepted as billed) with no fluid - I ran into a similar situation and because the procedure was actually completed, I was inclined not to use a modifier since I haven't been able to find any information that would indicate that the CSF lab would be included with the LP but rather that it would be coded separately for Pathology.  Apparently this is pretty common with dehydrated/feverish children that no CSF can be obtained...  And my (other)inclination was to bill just once on the account that they were all attempted in one 'sitting' and so the preparation work would have been done just once although sometimes I forget to take off my facility hat...


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