Modifiers 74 and 53

boozaarn

Guru
Messages
120
Best answers
0
Hi,

I am not a biller and a bit confused with the modifiers. Can someove explaine if modifier 53 for a profesional billing - for lets say an incomplete colonoscopy - should match with modifier 74 on the facility end for the same patient.

For example:
Example: 65-year-old female, asymptomatic, undergoing screening colonoscopy. The scope was advanced
to the cecum, but prep is incomplete and visibility was not acceptable, thus adequate screening could not be
completed. The patient is returning for re-evaluation after repeat prep. Modifier 53 would be added to 45378 for
the incomplete first attempt. If the second attempt is complete and no lesions are biopsied or removed, report
G0121 for the subsequent procedure

If I am coding for facility should I appened 74 on such scenario (w/o knowing how it was billed on the professional end?)

Thanks,
Booz, COC
 
Top