Wiki Essure device failure

[staz01]

I have a scenario where the physician had to stop the procedure because the device failed to relase, so the decision was made to discontinue and schedule a BTL for a later date. Can we bill 58565 with a mod 52? I know we can not bill with modifier 53 as it wasn't due to the patient's well being, but we did attempt and could not continue. Also, how will this change the charge for the BTL at a later date?

 

[capricew]

I have a scenario where the physician had to stop the procedure because the device failed to relase, so the decision was made to discontinue and schedule a BTL for a later date. Can we bill 58565 with a mod 52? I know we can not bill with modifier 53 as it wasn't due to the patient's well being, but we did attempt and could not continue. Also, how will this change the charge for the BTL at a later date?

Modifier 53 is not just for situations that threaten the patient. It is also for any extrenuating circumstance. I do believe this would fall into that criteria and that it would be appropriate to report modifier 53.
Modifier 52 would not be appropriate because the goal of the procedure did not occur. If the goal of the procedure occurred, but not all elements of the code descriptor were performed then it would be appropriate to report modifier 52.
Hope this helps

Caprice Walder, CPC