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how to code failed multiple spinal taps?

O

ollielooya

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Everett, WA
The physician was unable to establish CSF flow after 4 attempts were made. Choice of modifiers; 22 (to increase payment?, or 53 (reduce payment). Was looking at 52 as well. What would be the most accurate way to code this unsuccessful procedure(s)? I'm inclined to go with the 53, but the reduction for multiple attempts is a little unsettling. Asking for opinions from the experienced ones on here. -Suzanne E. Byrum, CPC
 
no takers on this one? Should I post in another thread?

Still looking for an answer while waiting on someone from this site to answer, please! ---Suzanne
 
Which CPT?

This is not my area of expertise, BUT ...

First, which CPT are you coding ... 62270 (diagnostic spinal tap) or 62272 (therapeutic for drainage of fluid)?

IF DIAGNOSTIC - From your description I would say the physician actually performed the entire procedure; he just didn't get the CSF he needed.
I would code the 62270.

IF THERAPEUTIC - I'd be inclined to use the -53, but would still code it multiple times ... you'll probably need a -76 modifier (repeat procedure) on the susequent attempt.

NOTE - I am NO expert in this area. I'm just trying to use the "logic" of CPT guidelines and modifier descriptions, and sort of "writing out loud."

Hope that was helpful.

F Tessa Bartels, CPC, CEMC
 
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