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Modifier for Incomplete colonoscopy

  1. #1
    Default Modifier for Incomplete colonoscopy
    Medical Coding Books
    Ok, this has probably been addressed before, but I am hoping someone will help me out. I am billing for the anesthesia portion. The colonoscopy was started but discontinued due to "poor prep." What modifier do I append to the anesthesia charge? Thanks!
    Missy Heuer CPC, CANPC

  2. #2
    Location
    ENGLEWOOD/DENVER
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    2,338
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    53 is for discontinued procedure (I dont do anesthesia billing but that would be the appropriate modifier for the surgeon)

  3. #3
    Location
    Bradenton, Fl
    Posts
    82
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    I agree with mbort, -53 is the appropriate modifier.

    In my text under anesthesia coding -53 is used when the physician elects to terminate or discontinue a procedure, usually because of risk to the patients well-being.

    Hope this helps!
    Angie Olson, CPC

  4. #4
    Location
    Duluth, Minnesota
    Posts
    1,133
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    I was just at a workshop today and this very issue came up - we were informed that yes, modifier .53 could be used if the colonoscopy was not completed - however - you could also code a "lesser" code - for example - a sigmoidoscopy "if" at least that much of the procedure was completed. I found that information very interesting! ... Of course documentation would have to support the procedure.

    so,...perhaps a little more research on the issue and report to see what would be the best way to code your scenario - modifier .53 vrs. sigmoidoscopy (or whatever).
    {that's my opinion on the posted matter}
    Donna, CPC, CPC-H

  5. Default
    I agree modifier 53 is correct
    Lalita, CPC

  6. #6
    Default
    Thanks All! Modifier 53 is what I was thinking as well, but I wanted to get some other opinions. I am aware of the coding to a sigmoidoscopy it they did go that far, but the modifier thing always seems to confuse me.
    Missy Heuer CPC, CANPC

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