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Recurrent shoulder dislocation

  1. Default Recurrent shoulder dislocation
    Medical Coding Books
    Okay here is the problem. The patient is a 14-year-old female who has had multiple anterior shoulder dislocations within a four-week time frame. All reduced by another physician in another hospital. My doc sees the patient in the emergency room for another dislocation. He takes her to surgery to reduce the shoulder. The shoulder reduces but when he sits her up it dislocates again. Since patient already has appointment for the next day with a shoulder surgeon in yet another city he halted further attempts at reduction and just placed her an immobilizer.

    Question: I can bill for the reduction, but do I need to use a 53 modifier on this?

    Any help would be appreciated.



  2. #2
    since he completed the reduction, yes you can code for it (providing his documentation supports all of the above from your post). No modifier is necessary.

  3. #3
    Default modifier 53
    i don't believe you can use modifier 53 simply because the procedure was completed and the complication happened after the fact. modifier 53 states "started but discontinued before completion due to the patient's condition".

    if the procedure was completed, you do not need to reduce your service.

  4. Default
    Thank you so much. I didnt think I needed to, but then you begin to second guess yourself. Have a great day to all.


  5. #5
    Default Shoulder reduction twice
    A pt is seen for a recurrent shoulder dislocation in the ER (8th one). The ERP reduces the dislocation, xray done, then shoulder dislocates again in the same setting. The ERP reduces again with some difficulty. Can we bill for the 2nd reduction?

  6. #6
    New Windsor, New York
    Default Modifier -76
    This sounds like the second reduction would need modifier -76 as well as supporting documentation why the procedure had to be repeated.


    Associate Director, Compliance Audit Program
    Westchester Medical Center Health Network
    Valhalla, NY

    Vice President - New Windsor NY Local Chapter 2019
    Past Secretary - Ellenville NY Local Chapter - 2016-17

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