CPT modifier
Modifier 53: Discontinued procedure
Modifier 53 is a CPT modifier. In plain terms: The physician stopped a procedure after it started because of a risk to the patient's well-being.
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- Modifier
- 53
- Type
- CPT (Level I) modifier, maintained by the AMA
- Plain description
- The physician stopped a procedure after it started because of a risk to the patient's well-being.
- How it is used
- Physician claims. Hospital outpatient and ASC claims use 73 or 74 instead.
- Claim form
- CMS-1500 item 24D, up to four modifiers per line. 837P SV101-3 to SV101-6.
The CPT descriptor is AMA copyright and is not shown here. The description above is written by Rivvi. Read the CMS guidance linked above for Medicare's rules.
Reduced or stopped services
Related modifiers
- 52Reduced services
- 73Discontinued before anesthesia (hospital outpatient or ASC)
- 74Discontinued after anesthesia (hospital outpatient or ASC)
- PTColorectal cancer screening test; converted to diagnostic test or other procedure
- 54Surgical care only
- 55Postoperative management only
- 51Multiple procedures
- 56Preoperative management only
Related pages
Questions
What does modifier 53 mean?
Modifier 53 is a CPT modifier. In plain terms: The physician stopped a procedure after it started because of a risk to the patient's well-being.
Is modifier 53 a CPT or a HCPCS modifier?
53 is a CPT (Level I) modifier. The AMA maintains CPT modifiers. Two-character codes with a letter, such as GT or XU, are HCPCS Level II modifiers from CMS.
Where does modifier 53 go on a claim?
On the CMS-1500 it goes in item 24D next to the procedure code. Each line holds up to four modifiers. On an 837P it goes in SV101-3 to SV101-6.
When is modifier 53 used?
Physician claims. Hospital outpatient and ASC claims use 73 or 74 instead.
What denial comes back when a modifier is wrong?
A missing or mismatched modifier often comes back as CARC 4. A modifier that was not valid on the date of service comes back as CARC 182. A bundling edit the modifier should have bypassed comes back as CARC 97 or 236.