Ob-Gyn Coding Alert
Be Sure To Include How Long Service Took For Modifiers 52, 53
Question: My ob-gyn attempted hysteroscopic D&C but “after 40 minutes of attempting to find the cervical os, it became clear that the patient’s cervical os was completely stenotic and the vagina was atrophic and this procedure would not be possible even under anesthesia. So, decision was made to abort the procedure.” How should I report this?
Kentucky Subscriber
Answer: You should bill 58558 (Hysteroscopy, surgical; with sampling [biopsy] of endometrium and/or polypectomy, with or without D&C) with modifier 53 (Discontinued procedure) — as long as the physician initiated the regional block for the procedure.
Modifier 52 (Reduced services) is another possibility, but because he apparently did not even get past the cervical os, you will have a harder time claiming a reduced service.
Action: Be sure to send in information about how long this service took. Time may influence the amount the insurer reduces your payment.
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