When should I utilize Modifier 53 (Discontinued Procedures)?
Appropriate usage guidelines for Modifier 53 instruct that, under certain circumstances, the physician may elect to terminate a surgical or diagnostic procedure. Extenuating circumstances or those that threaten the well-being of the patient may make it necessary to indicate that a surgical or diagnostic procedure was started, but discontinued.
Any procedure code billed with modifier 53 will be subject to carrier medical review. Supporting documentation in the patient medical records must be available upon request. Reimbursement will be made on an individual basis. Refer to WPS Medicare's Modifier 53 Fact Sheet 
for examples of appropriate and inappropriate use of Modifier 53.
Page Last Updated: Thursday, 18-Mar-2010 05:56:56 CDT
