Wiki IUD letter from ACOG - Help please

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anthemfamily

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I had an email forwarded to me from ACOG. They are saying to bill a discontinued IUD with a modifier -53. We do not use anethesia with our insertions. My understanding is that -53 is for dicontinued procedures after anesthesia was given. I have always billed as -52.

Also they are telling us that insertion/removal on same day are not inclusive and we should be billed seperately. In the past I have been told, in seminars and by ins co's that removal is included in re-insertion.

Now I am thinking I am crazy, I love when the non CPC's tell me how to code. Before I argue the point I want to make sure I am correct. Any feedback would be greatly appreciated!!!!

Traci, CPC
 
Appendix A in CPT does not indicate that anesthesia must be used when utilizing this modifier, the note indicates the modifier is not used to report the elective cancellation of a procedure prior to pt induction of anesthesia and/or surgical prep in the OR.

Modifier's -73 & -74 are used by Outpatient Hospitals & ASC's to report discontinued procedure(s) that require anesthesia.

It would appear to be appropriate to use the -53 in the case of the discontinued IUD insertion without anesthesia.

There is coding information which indicates that the removal of an IUD is not included in the insertion, therefore both would be reported when performed.

Hope this helps,
 
I agree with the response regarding the use of the 53 modifier. However, in the 2009 OBGYN Coding Companion, it states that if an IUD is removed and another is inserted at the same time, only the insertion (58300) should be reported.

Cindy Gallimore, CPC
 
CCI edits and The OB/GYN Coding Companion, do say the removal is incidental to the insertion, BUT, I agree with ACOG and will bill these regardless of the CCI edit and use the ACOG article to appeal if necessary. Be sure your Doc's document each procedure in a separate paragraph. We follow ACOG's recommendation.
 
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