tci Part B Insider - 2013 Issue 21

Reader Question: Report Finished Procedure Only

Question: After discussing the risks and benefits of both cryotherapy and photocoagulation for a retinal detachment repair with the ophthalmologist, the patient preferred photocoagulation. But the ophthalmologist had to discontinue due to the patient’s inability to tolerate the procedure and performed cryotherapy instead. Should I code 67105-53 as well as 67101? Answer: Code only the procedure the ophthalmologist finished (67101, Repair of retinal detachment, one or more sessions; cryotherapy or diathermy, with or without drainage of subretinal fluid), not the one he abandoned (67105, ...photocoagulation, with or without drainage of subretinal fluid). Appending modifier 53 (Discontinued procedure) would...

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