tci General Surgery Coding Alert - 2023 Issue Q4

Reader Question: Distinguish Modifier 52, 53

Question: During a screening colonoscopy, the surgeon documented that the patient did not prep properly. The surgeon was unable to complete the patient’s colonoscopy. Can we report the procedure anyway? California Subscriber Answer: You can report the procedure because the surgeon began the colonoscopy and should be paid for the completed work. However, you should not simply report the screening colonoscopy code, because the provider did not perform the entire service. Modifier: In this case, you should report the procedure code with modifier 53 (Discontinued procedure). Using modifier 53 in this scenario stops the clock and allows the...

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