AAPC - Back to school
Results 1 to 2 of 2

Thread: Modifier 52

  1. #1
    Join Date
    Apr 2007

    Default Modifier 52

    AAPC: Back to School

    I am double-checking to see how a case would be coded.

    The above codes list what would have been coded if the Radiological procedure had been performed. Instead, the patient was quickly examined by the Radiologist and it was determined that because of the discharge from the ducts, that the ductography was not a suitable procedure to be performed. To summarize the visit, quick hands on exam, review of the current mammo vs. that previous mammo, and the determination to send the patient for a surgical referral.

    What would be the correct way of reporting this or would this service not be reported at all? I struggle with submitting it was a modifier 52 for reduced services but this is all new to me and want to make sure that we bill it correctly.

    Someone told me that they would code it with a modifier 53 but modifier 53 is to be used when the procedure is discontinued after the induction of anesthesia and it was terminated because of the risk to the patient's well-being. This procecedure was cancelled only after the radiologist did a quick exam.

    Any ideas or feedback or advice would be greatly appreciated.

    Alison, CPC, CEMC

  2. #2
    Join Date
    Apr 2007
    Milwaukee WI

    Default Code the E/M

    I would code only the E/M performed and documented (i.e. the evaluation/exam/decision to refer). It does not sound as if any procedure was performed at all.

    Hope that helps.

    F Tessa Bartels, CPC, CEMC

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.