Practice Management

Hi Taleesha,

From my experience with surgical specialties, I believe that these can be billed.  For breast biopsies and other procedural cases like HSG, if we open disposables, we document the attempt, the materials and the reason for the procedure failure.  Then, it can be billed as an abandoned procedure.  I am unclear on actual payments (this is relatively new for us and our reporting is still down from the Change incident), but I think the documentation and attempt to bill are important. 

A CPC would better know the modifiers than I do, but 53 comes up on a quick search.  "When to use: a physician or other qualified health care professional uses this modifier to indicate that a procedure was discontinued due to extenuating circumstances or to protect the patient's well-being... Reimbursement is 25% of the allowable amount... Documentation: The medical record must include documentation that the procedure was started, why is was discontinued, and how much of the procedure was performed."

Hope this helps.

Heather