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Allergy testing that had to be discontinued

Marla Posted Wed 01st of June, 2016 15:01:59 PM
Occasionally when we do scratch testing on a patient, they will react to every single item so the results are unreliable as they may have hypersensitive skin. Can we bill for 95004 and add modifier -53 (Discontinued service)to this service or would this modifier be inappropriate. I am not sure if they modifier is able to be added to a nonsurgical procedure.
SuperCoder Answered Thu 02nd of June, 2016 02:31:27 AM
Hi, I think you may bill the code 95004 with modifier 53 (Discontinued service) in this scenario. According to the CPT guidelines, you should append modifier 53 if the physician elects to terminate a surgical or diagnostic procedure -due to extenuating circumstances or those that threaten the well-being of the patient. Modifier 53 can not be reported with E/M, time based codes, and those related to hospital outpatient and ambulatory surgery center services. Hope this helps! Thanks.

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