tci Part B Insider - 2003 Issue 17

Grasp the Difference Between Modifiers -52 and -53

Follow These Strategies for Billing Incomplete Procedures If your physician has to stop doing a procedure for some reason, your whole reimbursement just went down the tubes, right? Wrong!   Many coders and administrators don't understand the rules for billing for incomplete procedures - whether to bill an unspecified-procedure code or the code for a complete procedure plus a modifier. And there's the fact that there are two modifiers for incomplete procedures, -52 (Reduced services) and -53 (Discontinued procedure). Here are some handy tips:   -52 is for the physicians' decision to reduce a service. For example, the physician...

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