tci ED Coding & Reimbursement Alert - 2001 Issue 2

Failed Procedures: Reason for Halt Affects Code, Reimbursement

How should ED physicians code for a procedure that was attempted but failed? Just because you cant complete a procedure doesnt mean you shouldnt get reimbursed for it. The coding key is understanding the difference between modifiers -52 (reduced services) and -53 (discontinued procedure) and then providing thorough documentation to support the correct one. For example, a femoral line placement was attempted, the line established, wire placed and easily threaded into the vein. The dilator was then threaded over the wire into the vein. The wire stayed in place, triple-lumen catheter was advanced over the wire, and the first...

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