Wiki Discontinued Procedure and repeat?

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SydneyO

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Mukilteo, WA
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I have a patient whose procedure was discontinued today after the administration of anesthesia, so we are billing with the discontinued procedure modifier. However, the patient is coming back in a few days again for the procedure. Do we need to bill a repeat procedure modifier or will the insurance accept both claims?

Also, the procedure was 29881 and I saw in Supercoder that 53 is an acceptable modifier to bill discontinued procedure for the surgeon, but the modifier I was considering for the ASC side, 74, was not listed. Does anyone know why?

Thank you!! :)
 
Hello SydneyO,

I agree with coding CPT 29881 modifier 53 for physician fee and CPT 29881 modifier 74 for the ASC. I think that maybe why SuperCoder only mentioned the modifier 53 is because they were not discussing/advising on the facility (ASC) charge/coding. Also, when the patient comes back for the surgery and if it is completed in it's entirety than you do not need to bill with the repeat modifier nor any modifier other than LT or RT I believe. If the insurance denies than an appeal should be sent along with both op reports to show the discontinued procedure and then the procedure performed in entirety.


Hope this helps~

M. Hannus, CPC, CPMA, CRC
 
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