Wiki modifier 53

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ppt

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can provider bill for discontinue procedure -53 because his equipment failed/broken? patient was sedated but procedure never started. What is your recommendation for this type of scenario in term of what provider can bill for this sec?

Thank you for any advice.
 
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1. Can we append modifier -52 in situations involving equipment failure? Modifier -52 is designed for procedures that are halted due to a patient's condition or response to the procedure/test. While it is important to stop the test for patient safety resulting from equipment failure, this does not mean CMS will reimburse you for the partial test. CMS relies upon the provider to maintain all equipment in good working order. Providers absorb the costs associated with equipment failure.

2. Should we ever bill a test that is discontinued due to equipment failure? No.

3. Does a physician have to be involved in the discontinuation of a test in order to bill it? Any caregiver can stop tests/procedures due to patient reaction. It is assumed that once the physician is made aware of the situation, he or she will concur with stopping the test. The physician does not have to be the one to stop the test to qualify for modifier -52, but he or she must ultimately agree that the test was stopped for medical reasons-not convenience or equipment
 
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