tci General Surgery Coding Alert - 2004 Issue 8

If You're Cutting Fees for -52 And -53, You're Losing Out

If you're appending modifier -52 or -53 to a claim, you want to tell the payer why. Include a cover letter -- as well as the operative report -- with your claim to explain the extenuating circumstances that caused the physician to reduce or discontinue the procedure, says Laureen Jandroep, OTR, CPC, CCS-P, CPC-H, CCS, director and senior instructor for CRN Institute, an online coding certification training center based in Absecon, N.J. For instance, if the patient becomes uncooperative, you should note this as the reason for terminating the service (for instance, "During colonoscopy, the patient wished to...

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