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General Surgery Coding Alert

Reader Question:

Bail-out Cholangiogram Requires Modifier -53

Published on Thu Mar 01, 2001

Question: Our surgeon performed a laparoscopic cholecystectomy and, in the process, made multiple attempts to obtain a cholangiogram. Eventually, he abandoned the cholangiogram attempt. The attempted cholangiogram, however, was more work than the cholecystectomy. Can I receive payment for the surgeons additional work?

New York Subscriber

Answer: Typically, says Susan Callaway, CPC, CCS-P, an independent coding and reimbursement specialist and educator in North Augusta, S.C., surgeons cant bill when they bail out on a procedure. She suggests, however, that in this case modifier -53 (discontinued procedure) could be appended to the attempted cholangiogram (47563). Documentation that clearly explains why the procedure was attempted and failed will likely be requested by the insurer, she says, noting that payment may be less than if the surgeon successfully completed a cholangiogram despite the assertion that the failed cholangiogram required more effort and time.
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