tci General Surgery Coding Alert - 2002 Issue 10

Reader Question: Discontinued Surgery

Question: During a recent surgery, the patient developed uncontrolled bleeding, and the surgeon had to abandon the procedure. Anesthesia had already been administered. How should we bill? North Carolina SubscriberAnswer: You do not indicate the type of surgery, but because anesthesia was administered and the operation was begun, assign the proper procedure code with modifier -53 (Discontinued procedure) appended. When submitting the claim, include a detailed explanation of how much work was completed and the reason that the service was reduced. Include a record of the time spent giving pre- and postoperative care, as well as supplies used, and...

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