tci Part B Insider - 2009 Issue 32

PART B CODING COACH: Don't Let 'Discontinued' Spell Disaster for Your Claims

Learn the best ways to know when modifier 53 applies -- or doesn't. Your physician went into a procedure expecting things to proceed normally. You expected the same when the file came to you for coding, but now you see that things didn't go as planned. Do you report the case, or was the extent of your doctor's work covered by preop care? If you file the claim, do you append modifier 53 (Discontinued procedure) or just submit the appropriate surgical or anesthesia code? Read on for some expert guidance on how to handle these scenarios correctly every time...

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