tci Part B Insider - 2015 Issue 17

Part B Coding Coach: Discontinued Procedures: Watch the Clock to Know When Modifier 53 Might Apply

Plus: Document the specific reason for case cancellation. The descriptor for modifier 53 (Discontinued procedure) is simple enough, but do you know what constitutes a situation when a physician stops a procedure “due to extenuating circumstances or those that threaten the well-being of the patient,” according to the CPT® explanation? Keep our experts’ advice in mind to rest assured you’re meeting the necessary criteria. Build From a Basic Understanding Modifier 53 describes an unexpected problem, beyond the physician’s or patient’s control, that necessitates ending the procedure. The physician doesn’t elect to discontinue the...

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