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Need help coding discontinued procedure

  1. #1
    Default Need help coding discontinued procedure
    Medical Coding Books
    Here is the situtation: the patient presented to the office for removal of a forgin body. An x-ray reveals that the forgin body is 1.5 to 2 inches into the soft tissue. The area is marked, local anesthesia was administered, and the skin and surrounding tissue cleaned. At this point the patient changed his mind and did not wish to continue with the procedure. The anestesia wounds were bandaged and the patient dressed and left the office.

    My question is which modifer to append to the procedure code?
    52: Reduced Services doesn't feel right as all of the prep work was done and I feel like I'm jipping the physician.
    53: Discontinued Procedure doesn't quite fit because the difinitition states "Under certain circumstances, the physician may elect to terminate a surgical or diagnostic procedure. Due to extenuating circumstances or those that threaten the well being of the patient..."

    Any advise?

    Thank you

    Tammy Sue Keyes
    Fort Collins, Colorado

  2. #2
    Kansas City, MO
    In this instance 52 would be the correct modifier to use. The 53 does not fit this scenario.
    Angela Jordan, CPC, COBGC, AAPC Fellow
    Senior Managing Consultant
    Medical Revenue Solutions, LLC
    AAPC National Advisory Board - Southwest
    AAPCCA BOD Chair 2012-2013

  3. #3
    I agree with Angela. 53 would be appropriate. The doc wouldn't be jipped if you submit the documentation to show what was done. With the 53 mod, payment should be based on the documentation.
    Amy Crego, CPC, CPC-P, CPMA, CRC
    Vice President, Columbus, OH AAPC

    One can never consent to creep when one feels an impulse to soar. ~ Helen Keller

  4. #4
    I think it should be -53.

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