Ob-Gyn Coding Alert

READER QUESTIONS:

Inability to Place IUD Could Mean 1 of 2 Modifiers

Question: My ob-gyn tried to place an IUD, but the patient had a stenotic cervix. The physician could not place the device. What modifier should I use? Colorado Subscriber Answer: The answer depends on whose advice your payer follows. According to the American Academy of Obstetricians and Gynecologists (ACOG), you should report 58300 (Insertion of intrauiterine device [IUD]) and attach modifier 53 (Discontinued service). The ob-gyn started but discontinued the service, and your practice should be able to receive partial payment for this work. Opponents of this method point out that CPT's definition of modifier 53 states, "due to extenuating circumstances or those that threaten the well being of the patient, it may be necessary to indicate that a surgical or diagnostic procedure was started but discontinued." CPT's definition indicates that the physician must also have performed the surgical prep and anesthesia induction prior to discontinuing the procedure. Note that [...]
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in Revenue Cycle Insider
  • 6 annual AAPC-approved CEUs
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more

Other Articles in this issue of

Ob-Gyn Coding Alert

View All