Advanced Search

Anesthesia Coding Alert

You Be the Coder:

Carrier Helps Guide Modifier 53 Claims

Published on Wed Oct 10, 2007

Question: My provider had much difficulty with needle placement for a cervical transforaminal epidural injection. He discontinued the procedure because he returned blood -- and possibly cerebrospinal fluid (CSF) -- before injecting any medication in the epidural space. Which modifier should I report? Georgia Subscriber Answer: You usually report modifier 53 (Discontinued procedure) with the procedure code when your provider is unable to complete the service. If you're filing a Medicare case, include a note in CMS-1500 box 19 that briefly explains why your physician needed to stop the procedure. Report the procedure with 64479 (Injection, anesthetic agent and/or steroid, transforaminal epidural; cervical or thoracic, single level) and append modifier 53 to notify the payer that your physician discontinued the procedure.
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in Revenue Cycle Insider
  • 6 annual AAPC-approved CEUs
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more

Other Articles in this issue of

Anesthesia Coding Alert

View All