TWilliam2019
Guru
If a dr brings a pr in to do a cardio version. The pt has been given meds to be put asleep but nothing works in the pt. Wht can the dr charge for this visit? Thanks Kim
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- Thread starter TWilliam2019
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TWilliam2019
Guru
So even though the procedure was never started bc they couldn't get the pt asleep u still code it w the discontinued modifier and it gets pd. we thought maybe a high e/m visit wth the dictation. Any thoughts are greatly appreciated
mitchellde
True Blue
as long as the patient is in the room where the procedure is to be performed when the decision to discontinue is made, then yes you may bill it as a discontinued procedure, you will need a dx code from the V64 category as a secondary dx code to show the reason the procedure was discontinued.
jewlz0879
True Blue
I wonder if I have been interpreting 53 incorrectly then. It was my understanding you can't bill 53 for that circumstance but I could be wrong. See below:
Per CPT pg. 596
Discontinued Procedure: Under certain circumstances, the physician or other qualified health professonal may elect to terminate a surgical or diagnostic procedure. Due to extenuating circumstances or those that threaten the well being of the patient, it may be necessary to indicate that a surgical or diagnostic procedure was started but discontinued.
This circumstance may be reported by adding modifier 53 to the code repored by the individual for the discontinued service. *NOTE: This modifier is not used to report the elective cancellation of a procedure prior to the patient's anesthesia induction and/or surgical preparation in the operating suite.
I've only had examples like that of Allana's, where our patient was already induced and procedure started then aborted due to "x."
Per CPT pg. 596
Discontinued Procedure: Under certain circumstances, the physician or other qualified health professonal may elect to terminate a surgical or diagnostic procedure. Due to extenuating circumstances or those that threaten the well being of the patient, it may be necessary to indicate that a surgical or diagnostic procedure was started but discontinued.
This circumstance may be reported by adding modifier 53 to the code repored by the individual for the discontinued service. *NOTE: This modifier is not used to report the elective cancellation of a procedure prior to the patient's anesthesia induction and/or surgical preparation in the operating suite.
I've only had examples like that of Allana's, where our patient was already induced and procedure started then aborted due to "x."
I understand the hesitation in using the modifer 53 but in this instance (from what I gather from you) the patient was in the room, ready to go, was given the necessary medication specifically needed for this procedure but could not continue due to a complication. Just because the actual act of Cardioversion was not yet started does not mean this was not a discontinued service.
jewlz0879
True Blue
Ah, yes, I see your point. Hmm, interesting. I guess I believed it had to be a serious condition and not because the patient wouldn't fall asleep; guess that would be an extenuating circumstance.
Thanks!
Thanks!