Neurology & Pain Management Coding Alert

Question: How does one code for a failed procedure, such as an attempted but unsuccessful lumbar puncture (62270)? Is there a failed procedure modifier?

Anonymous Virginia Subscriber

Answer: If a neurologist attempts a lumbar puncture but is unable to obtain satisfactory results, the coder would assign the proper procedure code with a -52 modifier (reduced services). When the neurologist submits the claim, he or she should include a detailed explanation of how much work was completed and the reason that the service was reduced. The neurology practice should not reduce its charges but instead should allow the carrier to determine what the appropriate reimbursement would be under the circumstances.

Editors Note: Answers to these questions were supplied by Susan Callaway-Stradley, CPC, CCS-P, an independent coding consultant in North Augusta, S.C., and Margaret Mac, CMM, CPC, an independent reimbursement and coding consultant in Clearwater, Fla.