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Thread: Modifier 52 and 53

  1. #1
    Join Date
    Apr 2007
    New Haven, CT

    Default Modifier 52 and 53

    AAPC: Back to School
    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.

  2. #2
    Join Date
    Apr 2007
    Columbia, MO


    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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