Modifiers:
Take These 3 Steps to Keep Discontinued Procedure Claims Moving
Published on Thu Jun 02, 2011
Documentation and timing of cancellation make or break modifier 53.When your anesthesiologist or the surgeon sees some risk that could threaten the patient's health if the procedure continues, you might turn to modifier 53 (Discontinued procedure). Payers sometimes balk at reimbursing these claims, however, so let our experts help point you in the right direction for reimbursement.Conquer Electronic Filing ChallengesIn the past, you may have been told to submit paper claims reporting modifier 53 so you can append a written explanation with the claim. Now, in the age of HIPAA and electronic standards, you must first bill electronically, says Carol Pohlig, BSN, RN, CPC, ACS-FP, ACS-GI, senior coding and education specialist in the office of clinical documentation for Hospital of the University of Pennsylvania's department of medicine.Once you bill electronically with modifier 53, the payer might request more information. "If your physician is documenting properly, the anesthesia note should contain [...]