AAPC - Back to school
Results 1 to 7 of 7

Thread: Modifier 52 or 53

  1. #1
    Join Date
    Apr 2007

    Question Modifier 52 or 53

    AAPC: Back to School
    My surgeon discontinued a laparoscopic cholecystectomy due to extensive adhesions and the possibility of a CD stone and proceeded with a open procedure with and intraoperative cholangiogram. What is the appropriate coding for this surgical procedure? In addition to the open cholecystectomy code, can I use the 52 modifier with the Lap code? or should I use 53? Thanks for your input!
    Last edited by dlk; 03-24-2009 at 07:35 PM.

  2. #2


    Could you use 47605 as prime procedure and 49320 with mod 59 and dx: V64.41 as the secondary procedure? We have used this with success with several carriers.


  3. #3
    Join Date
    Apr 2007
    Milwaukee WI

    Default Code only open procedure

    When you convert a lap procedure to an open procedure, you code ONLY the open procedure. Use V64.41 as a secondary dx.

    F Tessa Bartels, CPC, CEMC

  4. #4


    I cannot remember who advised us to bill our lap to opens this way, but If we are attaching the operative note to the claim when we are submitting with a second code of 49320-59 and they are paying on it, are we committing some type of fraud?

    We obviously don't want to be doing something inappropriately but it seems odd the carriers would pay on this with all of our documentation if they did not feel it was appropriate. Just looking for some insight so we don't continue to code this way if it's definitely a no no.


  5. #5
    Join Date
    Apr 2007

    Wink Lap to Open

    If the physician converts from a lap procedure to an open procedure, you should only code for the open procedure.

  6. #6
    Join Date
    Apr 2007
    Duluth, Minnesota


    it's fraud when you KNOWINGLY code incorrectly (getting paid for something that is knowingly wrong)..

    so, now - IF you continue to do it, (knowing it is wrong)...it becomes FRAUD.

    gather your info on it. When converting from lap to open, you code only the open. Don't be attaching the .59 to the lap procedure.. code only the open.
    Donna, CPC, CPC-H

  7. #7


    Thanks for the confirmation, Sandy and Donna

Similar Threads

  1. Replies: 2
    Last Post: 09-18-2015, 01:17 PM
  2. Modifier 59 vs Modifier 91 for Laboratory
    By leahrey in forum Modifiers
    Replies: 1
    Last Post: 06-23-2015, 12:01 PM
  3. MODIFIER PT VS MODIFIER 33 Screening Colonoscopy
    By Ann Johnson in forum Modifiers
    Replies: 2
    Last Post: 07-19-2012, 07:08 AM
  4. Modifier 58 versus Modifier 78
    By Ramona03 in forum Medical Coding General Discussion
    Replies: 2
    Last Post: 06-04-2012, 12:10 PM
  5. Modifier 51 Versus Modifier 59
    By Sborkowski in forum Modifiers
    Replies: 3
    Last Post: 05-26-2009, 03:59 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts

Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.