Coding > Coding

modifier 53 vs. modifier 73/74

(1/6) > >>

jennifer8055:
Does anyone have experience using these for discontinued surgical procedures?  From what I have found, the -53 is for provider and -73/74 is for ASC's/Hospitals only.  One of my doctors has recently had to cancel several patients surgical procedures "day of" or within 24-48 hrs of scheduled surgery.  These have been cancelled due to illicit drug use by the patient that wasn't disclosed by the patient until the hospital does the pre-operative bloodwork/urinalysis and the patient tests positive. 

Can we bill the surgical procedure w/a modifier -53 showing it was discontinued/cancelled even though the patient was not in the operating room, but WAS at the hospital in pre-op, being prepped/worked up for surgery.  That's time that he could have scheduled another patients surgery or been in the office seeing patients, why can't he get reimbursed for it?

I can understand if they were cancelled a couple of days prior, but if it's cancelled day of surgery due to drug use or even the patients blood pressure being too high, shouldn't we be able to bill that?  Thanks in advance for any info !!

Jennifer

Merry:
http://wpsmedicare.com/j5macpartb/resources/modifiers/modifier-53.shtml
Patient should be in OR and probably already under anesthesia.  Is not used for cancellations in pre- op.  Think of how many surgeries are cancelled because someone has eaten before surgery or bp too high before surgery.   

DMK:
Or shows up sick or with at temperature....

jennifer8055:
thanks y'all.  that's what i was thinking based on what i have found and read.....that the patient has to be on the or table already prepped and ready for surgery.  it's aggravating when these patients do this -- here lately it's happening ALOT.  patients are showing up for surgery and testing positive for cocaine......and then act surprised when their surgery is cancelled......


 ???

Merry:
Just curious.  Are all patients tested for drugs before surgery?  Are these patients that have commercial insurance?   Wow.. It's not like you can double book surgery. 

Navigation

[0] Message Index

[#] Next page

Go to full version