Discontinued Procedure coding

71020 (radiologic examination, chest, two views, frontal and lateral) is ordered. However, only one view is performed. Correct reporting when a radiology procedure is reduced is to code to the extent of the procedure performed. You should only report the intended code with modifier 52 if no other radiology code exists for what was done. In this case, we can turn to code 71010 (radiologic examination, chest, one view, frontal) to describe what was done. So, you should assign 71010 and not 71020-52, even though 71020 was ordered.

CPT’s Appendix A mentions, “Under certain circumstances, the physician or other qualified health care professional may elect to terminate a surgical or diagnostic procedure. Due to extenuating circumstances or those that threaten the well being of the patient, it may be necessary to indicate that a surgical or diagnostic procedure was started but discontinued. This circumstance may be reported by adding modifier 53 to the code reported by the individual for the discontinued procedure.”

Modifier 53 describes an unexpected problem, beyond the physician or patient’s control that necessitates terminating the procedure.

Document the circumstances – the diagnosis code should reflect why the procedure is terminated.

This modifier is not used to report the elective cancellation of a procedure prior to the patient’s anesthesia induction and/or surgical preparation in the operating suite.

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