Wiki Discontinued Procedure Modifier

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muniraladha

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Hello, This is for a ASC facility claim. There was a Spinal Cord Stimulator trial and two leads were suppose to be used for the trial, however the doctor was unable to advance the second lead after a two tries because of some anatomical issue. The doctor decided to go ahead with the SCS trial with one lead only. The one other lead was wasted. This was billed to medicare as 63650x1 and 63650 with modifier 74 times 1. The 63650 with modifier 74 did not pay. Was this billed correctly and what would be the best way to indicate a wasted lead?

Any help with this will be appreciated.
 
It is appropriate to report the discontinued procedure with modifier 74, but under OPPS, CPT code 63650 is reimbursed by Medicare as a comprehensive APC, which means the same all-inclusive rate is paid regardless of how many procedures are billed. There would not be any additional payment for the wasted lead regardless of how it is billed.
 
Thank you for your response.
One of my co-worker was working on a similar claim and he was told an additional modifier was needed because the same code is being used on two different lines on the claim. Would you know if 51 or 76 is appropriate?
 
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