Don't Let 'Discontinued' Spell Disaster for Your Claims
Published on Thu Jun 04, 2009
Learn the best ways to know when modifier 53 applies -- or doesn't. Your anesthesiologist went into a procedure expecting things to proceed normally. You expected the same when the file came to you for coding, but now you see that things didn't go as planned. Do you report the case, or was the extent of your anesthesiologist's work covered by preop care? If you file the claim, do you append modifier 53 (Discontinued procedure) or just submit the appropriate anesthesia code? Read on for some expert guidance on how to handle these scenarios correctly every time. Know When Modifier 53 Applies You should report modifier 53 when a physician stops a procedure "due to extenuating circumstances or those that threaten the well-being of the patient," according to CPT. Modifier 53 describes an unexpected problem, beyond the physician's or patient's control, that necessitates ending the procedure. The physician doesn't elect to [...]