Modifier 52 or 53??

bbeatty

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Pt presents for colon. Dr. gets 15 cm from the rectum and finds a large tumor that cannot be traversed. Procedure is ended. Do I use a 52 or 53 modifier?
 
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53 modifier - discontinued

I would use the 53 modifier to denote a discontinued procedure. Physician had every intention of performing a complete colonoscopy, but had to discontinue the procedure for indicated reason.

Hope that helps.

F Tessa Bartels, CPC, CEMC
 

Sephardic

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I would use 53 as well for all insurances. I think it used to be that CMS wanted 53 and commercial would use 52, but the CPT book has a new heading before the colonoscopy section that states for patients scheduled for a colonoscopy and the scope is unable to go past the splenic flexure due to unforeseen circumstances append a modifier 53.
 
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