Wiki to modifier 53 or not

[sharon2014]

Doc had planned to do a gallbladder removal and a hernia repair at the same time on a patient. Doc removed the gallbladder but before he could get to the hernia repair part, the patient had anesthesia issues and they had to quit. So…. I know that I can bill the gallbladder part because it was completed but can I bill for the hernia repair with a modifier 53 because the hernia part was “planned”?

Thanks!
Sharon, CPC

 

[mitchellde]

In the modifier section of the federal register it states that you cannot bill for a canceled procedure once another procedure has been provided in the same operative session. Bill for only the procedure completed. The provider will be paid for the open and close as a part of the completed procedure, you cannot be paid twice for that which is why procedures are discounted, and since none of the hernia repair was performed, there is nothing to bill. You do not want the procedure that was completed to be reduced now.

 

[sharon2014]

Thank you!