Wiki Coding for "Attempted" procedure

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JoannaRupert

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Does anyone know the rule on billing an attempted procedure? We have several cases where the surgeon attempted one procedure then had to change to a different procedure. Do you bill the procedure that was actually done as the primary code with the attempted code secondary w/ a 53 modifier? Thanks
 
Joanne, I have the exact same problem. I did not see your thread unitl after I had transfered my thread from OB/GYN to GENSURG. Good luck! We are wondering here if ?the "intent" is more relevant then lysis. thanks!
 
We have this happen with our general surgeons as well. If you are speaking of a physician attempting a laparscopic procedure and having to switch to an open procedure, then you would only bill the open procedure.
 
Maine4Me, I am referring to when the intent of the procedure (Lap Tubal) was not done due to adhesions. adhesions were lysed. do we bill lap tubal with 53? or lysis? or 49320?
 
Code completed procedure only

If you switch gears midoperation and complete a different procedure than what you began, you code only the procedure you completed.

Depending on documentation, you MAY be able to use a -22 modifier - if sufficient additional work was clearly documented.

Hope that helps.

F Tessa Bartels, CPC, CEMC
 
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