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This one has me stumped

  1. #1
    Default This one has me stumped
    Medical Coding Books
    Dr. did transurethral resection of bladder tumor on pt (52240) Tumor was found to be very large and affected well over 90% of pts bladder. Dr. spent an hour resectioning tumor, and removed several ounces. However, procedure had to be terminated due to visibility becoming impaired. So basically I have an increased procedure and reduced procedure at the same time. Should I bill modifier 22 since he indicated that he spent excessive time on resection? Modifier 52 because even though time was excessive, he was unable to completely remove the tumor? Or should I use no modifier at all?

  2. Default
    If it were me, I would just bill for what he actually got accomplished. It sounds like he did do the 52240 based on the size of what he actually DID remove. Regardless of what he couldn't finish, I would still bill the 52240 with the 22 modifier. As long as his op note backs it up, it shouldn't be a problem. If he removed enough bladder tumor to be a 52240, of course!

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