tci Part B Insider - 2011 Issue 12

Reader Questions: Modifier 52 Applies to Terminated Procedures

Question: My cardiologist attempted a PTCA but determined after several attempts that it was impossible, so he terminated the procedure. Can I still bill it as code 92982?Answer: You may report the appropriate percutaneous transluminal coronary angioplasty (PTCA) code, such as 92982 (Percutaneous transluminal coronary balloon angioplasty; single vessel). But you should append modifier 52 (Reduced services) when the physician chooses to terminate the procedure.On the other hand: If the cardiologist had crossed the lesion and inflated the balloon, but documented that the outcome of the angioplasty was unacceptable, you should not append modifier 52.Or if...

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