Modifiers 52: Professional fee-for-service guidelines for modifiers do not apply in the clinical setting. Reduced, Failed, Aborted, Aborted… which one? What are the requirements for using modifiers 52, 73 and 74? These questions are common in the coding center world, and the answers never seem to be clear. Confusingly mix up the medical code instructions […]
Our hospital has been denied CPT code 52601 because the operative report does not mention the word complete. Although the operative note described the procedure in detail and the pathology report showed benign prostatic hyperplasia (BPH) tissue, why do we need to state the word complete? What does it mean in the CPT description? CPT […]
Modifier 74 description: Modifier 74 is used in the medical billing and coding field to indicate that a surgical procedure performed in an outpatient setting was terminated due to extenuating circumstances. When this modifier is applied to a billing code, it signifies that the procedure was initiated but discontinued before completion due to reasons beyond […]