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Modifier for Failed spinal tap procedure

  1. #1
    Somers Point New Jersey
    Smile Modifier for Failed spinal tap procedure
    Medical Coding Books
    Hi Friends,
    Hope you help me with this

    Our Pain management provider has performed spinal Tap procedure for a pateint on 2 different levels (L4-L5 & L5-S1) which was failed.
    Can we use 52 modifier with the CPT 62270 ?
    Do we have to send any extra documentation or letter from provider to explain the work done & reason for failure ?
    If yes please help us to provide the link for the same.

    Anuja, CPC-A.

  2. Default failed spinal tap
    If you review the Coding Clinic 3rd quarter, 2007 pgs 10 and 12 it states that you bill the 62270 once regardless of the number of attempts but it goes on to assume the last attempt was successful. I have always added the -52 when I have billed failed attempts and sent documentation with my claim. Rarely have I had an insurance company give me an issue. They simply reduce your normal reimbursement. However, I couldnt find anything documented to support the use of the -52 on this. Hope this helps.

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