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Attempted port a cath

  1. #1
    Location
    NEW ORLEANS
    Posts
    954
    Default Attempted port a cath
    Medical Coding Books
    can i code 36561 with a modifer 52 -maybe ??? doctor tried to go into subclavian vein but wire could not pass was attempted 3 x -?

  2. #2
    Default
    I would use mod 53 instead...discontinued procedure.
    adrianne, cpc

  3. Default
    we use modifier 52 when our surgeons can't insert the cath, modifier 53 is used when a procedure is discontinued due to the well being of the patient.
    Heather M
    CPC, GENSG

  4. #4
    Location
    ENGLEWOOD/DENVER
    Posts
    2,338
    Default
    trent, this is for an ASC right??? If so, you would use the 74 modifier rather than the 52.

  5. #5
    Location
    St. Louis, Missouri
    Posts
    262
    Default
    I would us a 53 modifier on this. It would have threatened the well being of the patient had they continued (torn or ruptured the vein), therefor it would meet the guidelines for modifier 53. Modifier 52 is used when a procedure is actually performed but is partially reduced.

    Melissa Blow, CPC

  6. #6
    Location
    NEW ORLEANS
    Posts
    954
    Default porta cath
    Thanks everone, This procedure was done at an ASC . modifer 52 not approved for asc , When i go to APPENDIX A by modifer 53 it tells me to go to 73 or 74. thanks for help. TRENT
    Last edited by codedog; 08-13-2008 at 01:31 PM.

  7. Default
    modifier 52 can be used when a procedure is not fully completed (when they cannot access the wire through the vein) thus the need for a reduced pmt amt

  8. #8
    Location
    Milwaukee WI
    Posts
    4,466
    Default 52 vs 53 modifier
    The way I was taught ...

    52 modifier is for a procedure that the physician has, at his/her discretion, partially reduced or eliminated a portion of. The procedure as planned and executed has a clear beginning, middle and end. It is planned to be less than the full procedure.

    53 modifier is for a procedure that the physician discontinues due to (per CPT definition) "extenuating circumstances or those that threaten the well being of the patient." The example I was given in my training was the colonoscopy that has to be discontinued because of inadequate prep.

    So given the scenario you posted, I'd use -53 modifier for physician coding(or -73 or -74 if ASC coding)

    F Tessa Bartels, CPC, CPC-E/M

  9. #9
    Location
    NEW ORLEANS
    Posts
    954
    Default
    thanks

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