tci Medicare Compliance & Reimbursement - 2014 Issue 11

Revenue Booster: Eliminate Confusion On When To Use Modifiers 52 and 53

You needn’t forego payment for incomplete service. When your surgeon stops a procedure, before you code for it, find out why. Learning how much of the procedure was actually performed could help you to decide which modifier to append. Read on to learn how to differentiate between the two modifiers for incomplete procedures. When the physician can’t complete a procedure, many coders are confused about when to use modifier 52 (Reduced services) and when to use modifier 53 (Discontinued procedure). But once you know why the physician decided not to finish the surgery or service, you can...

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