Gastroenterology Coding Alert

Anesthesia plays a role, too!When your gastroenterologist ends a procedure early, it automatically tells you to add a modifier to the procedure code. But what modifier? The use of modifiers 52 and 53 for incomplete procedures, in particular, has created unnecessary confusion among gastroenterology practitioners.Don't fall victim into the same trap by learning from these 2 scenarios.1. Procedure Spells 'Physician's Discretion'Sometimes, your gastroenterologist -- when performing a procedure -- decides to partially reduce or eliminate a portion of the code's requirements. In this case, you would use modifier 52 (Reduced services). The physician's discretion can be made prior or during a procedure.The CPT's descriptor would usually give you a hint -- when services your gastroenterologist carries out are less than those described. Before adding modifier 52 in your claim, however, make sure no other more appropriate CPT code describes the lesser procedure.Example: Your gastroenterologist started a colonoscopy, but his operational [...]