Wiki Pessary Insertion Completed but Unsuccessful

[abrookner232@gmail.com]

Hello,

I am not sure how to code the following scenario:

Patient was seen in the office for a pessary insertion. The procedure was completed but was not successful, and the provider billed 99213. However, the patient was not seen for a distinct reason from the procedure. Others have told me to code for the procedure and use modifier 53. However, I don't agree with this because the procedure was not discontinued- it was completed and unsuccessful. How do you code in-office procedures that are completed but the procedure did not work?

Thank you!

 

[nielynco]

Hello,

I am not sure how to code the following scenario:

Patient was seen in the office for a pessary insertion. The procedure was completed but was not successful, and the provider billed 99213. However, the patient was not seen for a distinct reason from the procedure. Others have told me to code for the procedure and use modifier 53. However, I don't agree with this because the procedure was not discontinued- it was completed and unsuccessful. How do you code in-office procedures that are completed but the procedure did not work?

Thank you!

As long as the work required was performed you bill for it, not an E/M service. I assume the pessary was placed but the patient could not tolerate it or perhaps it was the wrong size? You would not bill for the pessary supply, however, as the patient no longer has it.

 

[abrookner232@gmail.com]

Yes, various sizes were fitted but all were expelled. Thank you very much!