Ophthalmology and Optometry Coding Alert

Learn the best ways to know when modifier 53 applies -- or doesn't. Your physician went into a procedure expecting things to proceed normally. You expected the same when the file came to you for coding, but now you see that things didn't go as planned. Do you report the case, or was the extent of your doctor's work covered by preop care? If you file the claim, do you append modifier 53 (Discontinued procedure) or just submit the appropriate surgical code? Read on for some expert guidance on how to handle these scenarios correctly every time. Know When Modifier 53 Applies You should report modifier 53 when a physician stops a procedure "due to extenuating circumstances or those that threaten the well-being of the patient," according to CPT's definition. Modifier 53 describes an unexpected problem, beyond the physician or patient's control that necessitates stopping the procedure. The physician elects to [...]