Saturday, March 6, 2010

CPT modifier - 52 - Reduced services

Under certain circumstances a service or procedure is partially reduced or eliminated at the physician’s discretion. Under these circumstances the service provided can be identified by its usual procedure number and the addition of the modifier -52, signifying that the service is reduced. This provides a means of reporting reduced services without disturbing the identification of the basic service.

Use modifier 52 (reduced service) to indicate a service or procedure is partially reduced or eliminated at the physician’s election. When you report modifier 52, include office records, test results, operative notes, or hospital records to substantiate the reason for reporting a reduced service. If this information is NOT included, your claim may be denied/rejected.
Note: CMS has clarified that the 52 modifier should not be used with evaluation and management services.

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