Wiki Modifer for "attempted" procedure

[momo2]

Hopefully someone can advise me on whether a modifer is needed in the following case:

A lumbar transforaminal procedure was attempted after the administration of anesthesia (lidocaine) but the needle was withdrawn when doctor encountered bone.

My understanding of the use of modifiers has to do with stopping due to the well being of the patient. But, can I use a Reduced Service modifer 52 because it was eliminated?

The procedure occurred in an Outpatient Setting.

Thank you for any help!

 

[NFBarner]

Look at modifier 74 - "discontinued outpatient procedure after anesthesia administration".

 

[momo2]

I was thinking about that but since the procedure wasn't stopped due to the well being of patient, is -74 still usable? Does the doctor encountering bone necessitate the patient's well being being threatened or am I just overthinking this?

Thanks.

 

[capricew]

Hopefully someone can advise me on whether a modifer is needed in the following case:

A lumbar transforaminal procedure was attempted after the administration of anesthesia (lidocaine) but the needle was withdrawn when doctor encountered bone.

My understanding of the use of modifiers has to do with stopping due to the well being of the patient. But, can I use a Reduced Service modifer 52 because it was eliminated?

The procedure occurred in an Outpatient Setting.

Thank you for any help!

For starters, who are you billing for? The physician's claim or the facility?

For physician, you would report modifier 53 - mod 53 is not just for situations that threaten the patient, it is also for "other extrenuating circumstances"

For the facility, you would report modifier 74 - again, this is not just for situations that threaten the well being of the patient.

I do not believe that mod 52 is appropriate because this is reported when some or most of the intended procedure is performed and with what you described - that is not the case.

Good Luck!