Wiki Attempted angioplasty

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sandya

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Hi...what would make using the 52 modifier acceptable for an attempted intervention? This is what the doc states: "despite multiple attempts, we were unable to cross the proximal RCA 100% occulusion"...procedure was terminated. Do you need to be able to be in the lesion and at least attempt to inflate the baloon? Any suggestions? thanks. Sandy:)
 
cardiology

I have always posted the attempt with a 53 modifier attach the notes and gotten paid at a much reduced rate

Dolly Fader CPC CCSP CPC H;)
 
attempted angioplasty

I don't think modifier 53 would be appropriate, this was a reduced service not necessarily discontinued. I personally would use the 52 instead and that is what our practice uses as well.
 
Modifier 53, discontinued procedure, would be appropriate.

Life-threatening situation did not happen here, however extenuating circumstances did (extenuating - unusual, extreme).

modifier 52 - reduced services - only if they did something else there that was useful for the patient, per AMA:"...the procedure was not complete, but it did accomplish some result".
 
Last edited:
birma said:
Modifier 53, discontinued procedure, would be appropriate.

Life-threatening situation did not happen here, however extenuating circumstances did (extenuating - unusual, extreme).

modifier 52 - reduced services - only if they did something else there that was useful for the patient, per AMA:"...the procedure was not complete, but it did accomplish some result".
Click to expand...

Modifier 53 Fact Sheet
Definition
Indicates the physician elected to terminate a surgical or diagnostic procedure due to the patient's well-being.


Modifier 52 Fact Sheet
Definition
Reduced Service reports a partially reduced or eliminated service or procedure

Use 53 if procedure was stopped because patient became unstable.
Use 52 if procedure was stopped and patient is stable.
 
discontinued angioplasty

thanks...53 modifier is when the pt's life is threatened-correct? That's why I was going to use 52, because there was no mention of a life threatening situation. He just couldn't cross the lesion. thanks. Sandy:)
 
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