Medical Billing Forum

Coding => Coding => : debbied58 May 06, 2008, 12:58:56 AM

: Discontinued Essure reimbursement
: debbied58 May 06, 2008, 12:58:56 AM

I am looking for a sample letter or advice to explain to an insurance company about a failed Essure procedure.  The device is ver'y expensive and I thought that I would try to bill it with a 53 modifier but what else can I do to recoup the cost of the device?  The patients's tubes were not able to be seen so the procedure was discontinued.

: Re: Discontinued Essure reimbursement
: Michele May 06, 2008, 12:56:52 PM

Hi,

   I would recommend billing out the code for the essure procedure with the 53 modifier, like you said.  That modifier describes exactly what you are describing.    I don't think it is necessary to include a letter, the modifier should be enough.

Michele