Hello all,
Could you please suggest if modifier 53 is billable with ASA / Anesthesia codes (00100 - 01999 CPT)?
We used to bill 53 with ASA codes when a procedure got cancelled, however did not face denial until recently when Medicare denied a few claims stating that the modifier might be inappropriate. I have reviewed several articles that suggest that this modifier cannot be used with "time based codes" however they talk about procedure codes like psych codes, critical care codes etc., but not exactly about ASA codes.
The cases I am concerned about, got cancelled due to patient's threatened condition, so there is no possibility of using a 52 modifier (no basic requirement through the main surgery was achieved too).
Therefore it would be very helpful if you can share federal guidelines/documents etc. indicating if mod. 53 cannot be used with ASA codes. Thank you.
Could you please suggest if modifier 53 is billable with ASA / Anesthesia codes (00100 - 01999 CPT)?
We used to bill 53 with ASA codes when a procedure got cancelled, however did not face denial until recently when Medicare denied a few claims stating that the modifier might be inappropriate. I have reviewed several articles that suggest that this modifier cannot be used with "time based codes" however they talk about procedure codes like psych codes, critical care codes etc., but not exactly about ASA codes.
The cases I am concerned about, got cancelled due to patient's threatened condition, so there is no possibility of using a 52 modifier (no basic requirement through the main surgery was achieved too).
Therefore it would be very helpful if you can share federal guidelines/documents etc. indicating if mod. 53 cannot be used with ASA codes. Thank you.