Wiki Modifier 52 - patient scheduled

[NESmith]

Good Morning

Our clinic has a Mohs surgeon and he had a patient scheduled for a procedure but before the procedure could be done the patient's blood pressure went through the "roof" as he said.
His question is; Is there a way to bill for any part of the procedure since he had the suite booked for the procedure and staff was made available?

Thank You for your help with this matter.

 

[aaron.lucas]

If they were prepped and ready on the table and anesthesia had been started, the doctor could use modifier -53 showing that they had to abort due to a problem. -52 would not be appropriate because that is only for when the provider decides to do less work than normal. If they had not yet been prepped and under anesthesia then the doctor can't bill anything. As far as the clinic itself goes, as a facility you can use either modifier 73 or 74 depending on whether or not anesthesia had been started. In both of those cases though the patient has to be in the procedure room, on the table. If the patient's BP spiked in the waiting area and they cancelled the surgery then that wouldn't be billable. Hope this helps!