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Pulmonology Coding Alert

Reader Question:

Use Modifier -52 for a Discontinued Procedure

Published on Tue Jul 01, 2003

Question: If a physician determines that he doesnt need to complete a full procedure, such as thoracoscopy, (32650) once it has started, and the patient is already under anesthesia, which modifier should I append?
 
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Answer: You should use modifier -52 (Reduced services) for a procedure the pulmonologist aborts when he determines that the full procedure isnt needed; the physician effectively reduced the original service. For instance, a pulmonologist begins a biopsy (32405, Biopsy, lung or mediastinum, percutaneous needle), but the needle breaks and forces the physician to stop the procedure. You would then attach modifier -52 to 32405.
 
If the pulmonologist aborts a procedure because medical necessity requires it which is usually the reason why he or she would prematurely end a procedure then you would attach modifier -53 (Discontinued procedure). For example, if a patient cant medically tolerate a bronchoscopy (31622), you should append modifier -53 to 31622. To prove medical necessity for why the physician began the bronchoscopy, you would report a diagnosis code, such as an abnormal x-ray (793.1, Nonspecific abnormal findings on radiological and other examination of lung field). Also, cite the reason the pulmonologist halted the procedure, such as a ventricular arrhythmia (427.1, Ventricular tachycardia).

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