Know the Difference Between Modifiers 52 and 53 - AAPC
Apr 24, 2018 · If a provider discontinues a procedure due to risk to the patient, look to modifier 53. CPT® Appendix A tells us, “Under certain circumstances, the physician or other qualified health care …
Modifier 53 Fact Sheet - Novitas Solutions
We identified claims reporting modifier 53 (discontinued procedure) without supporting documentation or an explanation in the narrative of the claim. In order to help you avoid claim denials and future …
53 - JE Part B - Noridian
May 9, 2025 · This modifier allows the physician community to state the surgical procedure was discontinued due to extenuating circumstances or a threat to patient well-being.
Modifier 52 vs. 53: Which One to Use and When
Aug 15, 2025 · If Modifier 52 is about reducing a service on purpose, Modifier 53 is about stopping a service because something went wrong, either for the patient’s safety or due to unforeseen …
Modifier 53 Description, Examples & Accurate Usage Guide
Feb 4, 2025 · Billing teams use modifier 53 when there is a critical reason for discontinuing a procedure. These include extenuating circumstances (unexpected events beyond anyone’s control), like …
Modifiers for Unsuccessful Procedures: A Complete Guide
Aug 13, 2024 · Modifier 53 is used when a process begins but must be terminated owing to unexpected problems. Both modifiers necessitate thorough documentation, but the emphasis differs.
Modifier 53; Discontinued Procedure - Regence
CPT modifier 53 indicates a procedure was discontinued by a physician or other qualified health care professional and may not be reported by facilities. Reimbursement for discontinued procedure with …
Modifier 53: When & How to Use It in Billing - isolvercm.com
Proper use of modifier 53 improves transparent billing processes in addition to expressing ethical medical judgment. Appropriate reporting through this modifier guarantees that healthcare …
Procedure Coding: When to Use the Modifier 53 - Continuum
Feb 19, 2019 · Modifier 53 is for professional physician services and would not apply to ASC procedures. Most often, the discontinuation of the procedure is due to unforeseen extenuating …
Modifier 53 in Medical Billing - Usage, Examples & Guidelines
Sep 19, 2025 · Modifier 53 is a CPT (Current Procedural Terminology) code modifier used to indicate that a diagnostic or surgical procedure was started but had to be discontinued due to unforeseen, life …