Pulmonology Coding Alert

Question: During the treatment of a patient, a CVP line could not be successfully placed. Can this attempted procedure still be billed the same as if it were completed?

New York Subscriber

Answer: You can bill the service, as long as modifier -53 (discontinued procedure) is attached.

Note: The modifier covers discontinued procedures, but not when cancellation was elective prior to anesthesia and/or surgical preparation in the operating room.

When you use modifier -53, your claim needs to be a paper one, with documentation explaining why the procedure was stopped or unsuccessful. If the carrier recognizes the modifier, they will want to know how far the procedure went so they may prorate payment. In this case, you would code 36489-53 (placement of central venous catheter; percutaneous, over age 2; discontinued procedure) for the attempted placement of the CVP (central venous pressure) line. This will identify that the procedure was started but discontinued because of the threat to the health and welfare of the patient.