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Attempted port a cath

codedog

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can i code 36561 with a modifer 52 -maybe ??? doctor tried to go into subclavian vein but wire could not pass was attempted 3 x -?:confused:
 

heathermc

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we use modifier 52 when our surgeons can't insert the cath, modifier 53 is used when a procedure is discontinued due to the well being of the patient.
Heather M
CPC, GENSG
 

mmelcam

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I would us a 53 modifier on this. It would have threatened the well being of the patient had they continued (torn or ruptured the vein), therefor it would meet the guidelines for modifier 53. Modifier 52 is used when a procedure is actually performed but is partially reduced.
 

codedog

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porta cath

Thanks everone, This procedure was done at an ASC . modifer 52 not approved for asc , When i go to APPENDIX A by modifer 53 it tells me to go to 73 or 74. thanks for help. TRENT
 
Last edited:

heathermc

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modifier 52 can be used when a procedure is not fully completed (when they cannot access the wire through the vein) thus the need for a reduced pmt amt
 
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52 vs 53 modifier

The way I was taught ...

52 modifier is for a procedure that the physician has, at his/her discretion, partially reduced or eliminated a portion of. The procedure as planned and executed has a clear beginning, middle and end. It is planned to be less than the full procedure.

53 modifier is for a procedure that the physician discontinues due to (per CPT definition) "extenuating circumstances or those that threaten the well being of the patient." The example I was given in my training was the colonoscopy that has to be discontinued because of inadequate prep.

So given the scenario you posted, I'd use -53 modifier for physician coding(or -73 or -74 if ASC coding)

F Tessa Bartels, CPC, CPC-E/M
 
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