Wiki Failed iud placement

Create Wiki
P

PennyG

Networker
Messages
89
Best answers
0
My physician was attempting to insert an IUD, but was unable to do so, due to being unable to visualize and grasp the cervix. Even using instruments from Surgery. How do I code this failed attempt?
 
Do not use a 53 modifier. 53 modifier is for use when the procedure was discontinued due to patient's well being. Use a 52 modifier instead. You may need to submit a report to indicate the amount of work done.

Becky, CPC
 
52 or 53 for failed IUD insert

Does anyone have any solid information on the correct way to bill for a failed attempt for IUD insert. Our coding group is divided on this issue. ACOG says to use 53 but every other article I read says to use 52. Any input would be much appreciated.

Typically these are failed because stenosis cervix or patient did not tolerate the procedure. In my mind this doesn't seem to fit with the modifer 53.
 
We use the 53 modifier if the patient could not tolerate the procedure for whatever reason- discomfort, stenosis. If you opened and used the IUD but could not continue- you will also need to include this in your billing to get reimburses for the device (unless it was order thru a pharmacy and the patient paid the pharmacy directly).
If it was due to an error on the physician's part- I will probably use the 52 modifier.
 
IUD 52 vs 53

53 is used for when it becomes a patient safety issue (shortness of breath, uncontrolled bleeding,etc).
52 is going to be used for a service that is not fully completed by the physician due to numerous reasons (patient is set for an IUD insertion but then the physician can not sound the uterus not allowing them to move forward). Although the procedure was set and ready to go the physician depending on their compensation model may elect to bill 58300 mod 52 - telling the insurance company that "hey we started, we prepped the patient we did all we were suppose to be except physically put an IUD in, but we tried." so 52 is a modifier that I think is paying and informational, it's there to tell the carrier to not pay the full allowable because we didn't do everything stated in the definition of this CPT code but we set out to accomplish this and we failed.
 
You must log in or register to reply here.
Top