solocoder
Expert
I have heard that a 52 modifier should be appended when a physician chooses to leave a surgical incision open to drain rather than closing it.
Does anybody else have any different guidance on that?
Our MCR carrier's Modifier 52 fact sheet says:
Procedures for which services performed are significantly less than usually required may be billed with the "52" modifier.
Wondering if leaving the wound open is "significantly less"?
A couple of insurance companies websites that I've read say charges submitted with a 52 will be paid at 50% of the allowable charge. 50%! To me that seems unreasonable for a procedure, such as an amputation, that is fully completed except for closure.
Any thoughts?
Does anybody else have any different guidance on that?
Our MCR carrier's Modifier 52 fact sheet says:
Procedures for which services performed are significantly less than usually required may be billed with the "52" modifier.
Wondering if leaving the wound open is "significantly less"?
A couple of insurance companies websites that I've read say charges submitted with a 52 will be paid at 50% of the allowable charge. 50%! To me that seems unreasonable for a procedure, such as an amputation, that is fully completed except for closure.
Any thoughts?