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Using MOD 52 on intended Ablation

  1. Default Using MOD 52 on intended Ablation
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    We are looking for some quidance for using 52 MOD when the procedure intended was to do Ablation 93651. They went in and did EP Study but never got to do Ablation for the fact the arrhythmia was not inducable so the procedure was discontinued after the Study. We are getting conflicting advice stating that Medicare guidance allows you to downcode the intended procedure. Very cautious about this.....All Help and comments are welcome.

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    Quote Originally Posted by lisanolan View Post
    We are looking for some quidance for using 52 MOD when the procedure intended was to do Ablation 93651. They went in and did EP Study but never got to do Ablation for the fact the arrhythmia was not inducable so the procedure was discontinued after the Study. We are getting conflicting advice stating that Medicare guidance allows you to downcode the intended procedure. Very cautious about this.....All Help and comments are welcome.
    If there are codes that describe the procedure(s) that were done, you would only code those. I think the only time you would code an intended procedure code with a 52 modifier is if that actual procedure was begun, but was not completed due to complication.
    Arlene J. Smith, CPC, CPMA, CEMC, COBGC

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