Wiki Discontinued procedure

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I need some insight on this one:

My provider had to discontinue an outpatient hysteroscopy because the cervix was too sharply angled to admit the hysterscope. She ended up using a curette to do a biopsy of the uterine cavity and cervical canal instead. I'm looking at the following:

58558,74
58120,51

Suggestions?
 
discontinued procedure

I wouldn't code the stopped/discontinued procedure. I believe when you bill a discontinued service it means nothing else was done to the patient as the procedure had to be terminated because the patient had a problem. I would bill only for the biopsy with curette since that was actually done.
 
I wasn't expecting payment for the discontinued procedure, but the patient has Tricare and the referral is specific for the 58558 code. I thought that would help with the documentation as to why the procedure was changed. Would you still leave it off?
 
discontinued procedure

ok, I understand(if I sent this before I'm sorry).
Because your authorization is tied to the discontinued procedure, it may not make a difference how you submit the claim as you will more than likely end up appealing. BUT if it were me, code the discontinued procedure--use modifier 53 for physician and not 74--and attach a zero charge. code the procedure actually done with the charge. Attach op note detailing on the op note the discontinued procedure and the procedure done. attach to claim and send in. Insurance companies are aware that procedures can change once the surgery begins but since you have an authorization for a procedure that wasn't done, your claim may be denied and you will have to appeal. You may want to contact the authorization department and let them know that the procedure authorized was not done so that they can document that. It couldn't hurt and might help if appeal needed.
If you are lucky, you will be paid straight out with no problem, but if not, do not worry, you will get it on the appeal.
Good luck.
 
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