Modifer 52 vs 53

TUNISHA20

Contributor
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Teaneck, New Jersey
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Hello fellow Coders,
I need some help with modifier 52 vs 53. My surgeon was scheduled to perform craniotomy for 7 hours for brain tumor, meningioma. He is using Cpt 61519. Surgeon had to abort surgery after 5 hours because he was not able to get to the trigeminal nerves due to massive scar tissue and anomalies. Would I add modifier 52 or 53? Surgeon performed surgery in Inpt. Hospital. FYI, he will not be able to perform this surgery at a later date, too dangerous.

Thanks,
 

mk2001

Networker
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75
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Hello fellow Coders,
I need some help with modifier 52 vs 53. My surgeon was scheduled to perform craniotomy for 7 hours for brain tumor, meningioma. He is using Cpt 61519. Surgeon had to abort surgery after 5 hours because he was not able to get to the trigeminal nerves due to massive scar tissue and anomalies. Would I add modifier 52 or 53? Surgeon performed surgery in Inpt. Hospital. FYI, he will not be able to perform this surgery at a later date, too dangerous.

Thanks,

I believe it would be 53. Medicare 53 fact sheet has definition "Indicates the physician elected to terminate a surgical/diagnostic procedure due to the patient's well being" and usage of "A discontinued procedure after induction of anesthesia".
 

SharonCollachi

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Just FYI, the 52 modifier is for when a procedure is done that is less than the described code. For instance, if a code is bilateral and you do only one side, then you append 52.
If the description is "unilateral or bilateral", then no 52 for unilateral.
 

TUNISHA20

Contributor
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Teaneck, New Jersey
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Just FYI, the 52 modifier is for when a procedure is done that is less than the described code. For instance, if a code is bilateral and you do only one side, then you append 52.
If the description is "unilateral or bilateral", then no 52 for unilateral.
Hi Sharon, thank you so much for explaining this for me. I really appreciate it. :)
 
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