ED Coding and Reimbursement Alert

Reader Questions:

Consult Examples for Help With -52 and -53

Question: I'm trying to figure out how to utilize mod-ifiers -52 and -53. What is the difference between the two?
               
South Dakota Subscriber

Answer: The May 1997 edition of CPT Assistant offers some help on deciding when to append modifiers -52 (Reduced services) and -53 (Discontinued procedure). According to this reference, "Modifier -53 differs from -52 in that a patient's life-threatening condition precipitates the terminated procedure. You would not append modifier -53 to report elective cancellation of procedures prior to anesthesia induction or surgical preparation in the surgical suite, including situations where cancellation is due to patient instability."
 
Also, check out the article "Pose 1 Crucial Question to Negotiate -52 and -53" in the August 2004 issue of ED Coding Alert for further explanation about when to choose which modifier.

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