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Modifier 52 and 53

  1. #1
    Location
    New Haven, CT
    Posts
    32
    Default Modifier 52 and 53
    Exam Training Packages
    Coding for diagnostic radiology procedures - hospital technical:

    Radiology procedures interrupted or aborted:

    1) Inpatient: Procedures post conscious sedation aborted determined by physician but not because of extenuating circumstances or threatening wellbeing of patient, perhaps just patient anxiety - or physician couldn't advance scope or catheter, ect...: no modifier or modifier 52? (for our outpatients post-anesthesia we would bill modifier 74).

    Would anxiety be considered threatening wellbeing ?

    Is modifier 53 strictly for professional (physician) reporting ?

    Thanks, in advance, to anyone who can clarify these two modifiers.
    Shar

  2. #2
    Location
    Columbia, MO
    Posts
    12,570
    Default
    53 ia a physician only allowed modifier. The facility uses 73 when anesthesia has not yet been administered and 74 after anesthesia. The patient must be in the procedure room when the decision to discontinue is made. The 52 is used either physician or facility and is used when a reprtable portion of a procedure is done but the entire procedure could not be completed.

    Debra A. Mitchell, MSPH, CPC-H

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