This was performed in an ASC but I am billing for the physician. Would modifier 52 be appropriate here? Thanks.
POSTOPERATIVE DIAGNOSES: 1. Fertile male.
2. Morbid obesity.
PROCEDURE PERFORMED: Attempted vasectomy.
ANESTHESIA: Local.
DETAILS OF PROCEDURE: This gentleman presented to us and was felt to be a
reasonable candidate to go forward with a vasectomy. He was brought to the procedure room, prepped
and draped in a sterile fashion, and laid in supine position on the table. I anesthetized his skin and
attempting to isolate the right vas in spite of doing so for at least 20 minutes if not a little longer. I was
unable to do so. So, I talked to him and I felt that he is a more suitable candidate if he wishes to go
forward with the vasectomy to do this with MAC or general anesthetic either one. Unfortunately, he may
not meet the BMI requirements for anesthesia. He is 6 feet tall but he is about 375 pounds, which is far
as he knows places him at a BMI about 50.2. So, we will see what anesthesia has to say, the gentleman
may have to employ other means of birth control until he can get the weight off to become a reasonable
surgical candidate. We are happy to try to help him but he needs to help us help him.
POSTOPERATIVE DIAGNOSES: 1. Fertile male.
2. Morbid obesity.
PROCEDURE PERFORMED: Attempted vasectomy.
ANESTHESIA: Local.
DETAILS OF PROCEDURE: This gentleman presented to us and was felt to be a
reasonable candidate to go forward with a vasectomy. He was brought to the procedure room, prepped
and draped in a sterile fashion, and laid in supine position on the table. I anesthetized his skin and
attempting to isolate the right vas in spite of doing so for at least 20 minutes if not a little longer. I was
unable to do so. So, I talked to him and I felt that he is a more suitable candidate if he wishes to go
forward with the vasectomy to do this with MAC or general anesthetic either one. Unfortunately, he may
not meet the BMI requirements for anesthesia. He is 6 feet tall but he is about 375 pounds, which is far
as he knows places him at a BMI about 50.2. So, we will see what anesthesia has to say, the gentleman
may have to employ other means of birth control until he can get the weight off to become a reasonable
surgical candidate. We are happy to try to help him but he needs to help us help him.