# Modifier -53 !!!!



## sandyy2510 (Apr 15, 2010)

I have 2 questions regarding this modifier...
1.  if there are 9 scheduled procedures and the surgery is stopped after anesthesia for extenuating circumstances DO ALL 9 CPT CODES ARE BILLED WITH MODIFIER -53 OR JUST THE PRIMARY CPT CODE?

2. If an assist surgeon is required for the above surgery, could I submit a claim for all 9 CPT CODES FOR THR ASSISTANT SURGEON?

I couldn't fine any information on CMS or AMA...HELP!!!!


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## FTessaBartels (Apr 15, 2010)

*Had the surgery actually started?*

Had the surgery actually started?

If NO ...  We had a case not too long ago where the patient went into anaphylatic shock after anesthesia administered but before the surgeon had begun to do anything (patient was still being positioned/draped).  We did NOT bill anything for surgeon. 

If surgeon *had* made an incision to begin the procedure, I would code the procedure being started with a -53 modifier. I would not code all 9 procedures.  

Just my take on things. Hope that helps.

F Tessa Bartels, CPC, CEMC


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## sandyy2510 (Apr 16, 2010)

Where can I find any written guidelines on this modifier?

The doctor did not start the surgery


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## Jenny8675309 (Apr 16, 2010)

from CPT Assistant Archives (4th Quarter 1990 - present) - Copyright American Medical Association 2003
Hospital Outpatient Reporting Part IV: Use of the CPT Modifiers '52,' '58,' '59,' '73,' '74,' '76,' '77,' '78,' and '91' (September 2003)

*Modifiers for "Discontinued" Procedures*

"These two modifiers are also discussed together to clarify and differentiate usage according to specific CMS policy. Effective January 1, 1999, a new CPT modifier '73,' Discontinued Out-Patient Hospital/Ambulatory Surgery Center (ASC) Procedure Prior to the Administration of Anesthesia, replaced modifier '52' to identify discontinued services occurring under the stated circumstances. Before modifier '73,' *modifier '53' was used to indicate when a procedure was terminated after the induction of anesthesia (eg, local, regional block(s), or general anesthesia)* or after the procedure was started (incision made, intubation started, scope inserted)."

Also, if the assistant surgeon was never utilized you wouldn't bill for their services either. Hope this is useful.


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