Ob-Gyn Coding Alert

Question: One of our doctors started a laparoscopic procedure and 90 percent of this procedure was done when he had to change to an open procedure. Should we use modifier -53 to indicate this?

Anonymous KY Subscriber

Answer: No, you should not append a -53 modifier (discontinued procedure) in this situation. Modifier -53 should be used only if the surgery was stopped completely. There are two coding options for this scenario.

1. Code only for the more expensive procedure (in this case the open procedure), and in the event it took a significant amount of time you would append modifier -22 (unusual procedure services). But it is important to remember the use of modifier -22 will require comprehensive documentation in order to receive reimbursement.

2. Bill for the open procedure on the first line of the claim and the laparoscopic procedure on the second line with a -52 modifier (reduced services) because the laparoscopic procedure failed.

Melanie Witt, RN, CPC, MA, program manager for the Department of Coding and Nomenclature at ACOG, explains that the best option may be using the -22 modifier, as long as there is documentation to support its use.