What is modifier 53?

Modifier 53 is used to indicate when a procedure or service is partially or completely cancelled or discontinued by the provider due to unforeseen circumstances or reasons beyond their control. This modifier is often used in situations where a procedure is started but cannot be completed, or when a service is discontinued before it is finished.

When using modifier 53, the provider must provide documentation explaining the reason for the cancellation or discontinuation of the procedure or service. This information is necessary for proper billing and reimbursement purposes.

It's important to note that modifier 53 is not used to indicate that a procedure was not medically necessary or was not performed due to patient choice. In these cases, a different modifier or reason code may be appropriate.

Overall, modifier 53 helps to accurately reflect the circumstances surrounding the cancelled or discontinued procedure or service in the medical billing and coding process.