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Wiki Modifier 53!!!

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sandyy2510

Networker
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Location
Jamaica/ Manhattan
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I have 2 questions regarding this modifier...
1. if there are 9 scheduled procedures and the surgery is stopped after anesthesia for extenuating circumstances DO ALL 9 CPT CODES ARE BILLED WITH MODIFIER -53 OR JUST THE PRIMARY CPT CODE?

2. If an assist surgeon is required for the above surgery, could I submit a claim for all 9 CPT CODES FOR THR ASSISTANT SURGEON?

I couldn't fine any information on CMS or AMA...HELP!!!!
 
Was the physician able to do all 9 procedures? If not you can't bill for them even though they were scheduled. I would just bill for what he was able to do and add mod 53 to each procedure if he was not able to fully complete them. I would also send the claim w/op notes. Same with the assist charges. I have never had this situation happen before so this is just my opinion hope it helps.
 
Look in the CPT book apendix A it gives a good descrition about mod 53. If the Dr. did not do anything on the patient no incisions or exams then I don't think you can bill for anything.
 
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