Wiki Incomplete Flex Sig vs. a No Charge

[rlmiller]

How would you code a Flex Sig that a scope could not be inserted due to stool. I know we cannot bill an incomplete procedure because the scope could not be inserted. Can we bill a facility charge and not a physician charge? Any suggestions?

 

[capricew]

for the facility you would bill the intended proc with modifier 74 if the patient was in the room where the procedure was to occur and induction of anesthesia was administered.

if patient was in the room where the procedure was to occur but anesthesia had not been induced then you would bill the intended procedure with modifier 73.

Hope this helps!

 

[rlmiller]

Thanks, for the information. That is how we billed and will cross our fingers for payment.

 

[capricew]

Usually, your payer will request the op report to see at what point the procedure was stopped.......

 

[hbeard]

This is a similar situation as an incomplete colonoscopy due to a poor prep. The flex sig was attempted but unable to be completed so -53 and -74 for facility charges is correct.