Urology Coding Alert

Question: How do you charge for a discontinued procedure (-53 modifier)? What would the fee be for Medicare and private pay patients? How is it determined?

Anonymous Va. Subscriber

Answer: When submitting a claim for a procedure with the -53 modifier, do not reduce your fees in advance. Send an operative report so that the insurance carrier can make a determination on the amount to be paid, then do your write-offs afterward.