tci Medicare Compliance & Reimbursement - 2014 Issue 11

5 Easy Billing Tips for Modifiers 52 and 53

File preparation and clear documentation are the keys to getting these claims paid. When you’re reporting codes appended with modifiers 52 (Reduced services) and 53 (Discontinued procedure), use these quick methods from coding experts to help ensure your claims will be paid.   1. Prepare for modifier 53 documentation requests. Because modifier 53 and some modifier 52 claims involve varying circumstances, payers’ systems could kick them out, and they will review them manually. HIPAA, however, requires that you file all claims electronically, which means you may have to wait for the denial and/or “request for additional information&rdquo...

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