tci Part B Insider - 2021 Issue Q3

Modifiers: Utilize 52, 53 for Stopped Surgery Claims

Caution: Know the particulars on modifier 53 to avoid denials. Occasionally, surgeons need to stop surgeries, and it’s critical that you know how to deal with and code a “stopped surgery” claim. That way, you might be able to utilize a pair of modifiers to get partial payment for services rendered. Which ones? Modifiers 52 (Reduced services) and 53 (Discontinued procedure) are for use when the provider must stop performing a service. Which one you use, and when, is the biggest challenge for coders. There are other challenges, too; getting modifier 52/53 claims paid can be a...

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