Wiki Aspiration that didn't aspirate.......

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nneecole44

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My doctor tried to aspirate fluid from a patients knee but nothing came out. Can I code the attempt or just code an E & M?
 
nneecole said:
My doctor tried to aspirate fluid from a patients knee but nothing came out. Can I code the attempt or just code an E & M?
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You still bill for the procedure that was done. Does not matter that nothing was aspirated, as long the documentation shows all the steps in the procedure and the result, you can code it and you don't have to reduce it with a 52 modifier.
 
52 I believe is intended for procedures that accomplished some result but less then expected for the procedure. Personally I would use an E/M code ...no global and the E/M probably depending on the documentation would reimburse about the same; again depending on the documentation that the physician provided.
 
gherimichele said:
52 I believe is intended for procedures that accomplished some result but less then expected for the procedure. Personally I would use an E/M code ...no global and the E/M probably depending on the documentation would reimburse about the same; again depending on the documentation that the physician provided.
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The 52 is actually intended for procedures that were substantially incomplete, such as the patient got anesthesia (local or general) but they were not able to continue with the procedure. The fact that no fluid came out when they put the needle in the knee does not mean that the procedure was not completed, or that it failed. It just means they did not get the result they expected from the procedure.
 
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