annmoore
New
Can I bill an attempted procdure in an ASC outpaient setting?
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Wiki Bill attempted procedure ASC?
- Thread starter annmoore
- Start date
nsteinhauser
Expert
Short answer - yes - but what is the scenario and how was it dictated? Depending on the payer, if you use a -73 or -74 modifier (both approved for ASC use), you may or may not get reimbursed for it and you may need to send documentation.
"Elective cancellation" of a surgery prior to administration of anesthesia should not be reported, per CPT. But if it was discontinued for some reason by the surgeon before or after the administration of anesthesia, you could submit with the appropriate -73 or -74 modifier.
"Elective cancellation" of a surgery prior to administration of anesthesia should not be reported, per CPT. But if it was discontinued for some reason by the surgeon before or after the administration of anesthesia, you could submit with the appropriate -73 or -74 modifier.
TracyHecox
Guest
What happens if they are only in the pre-op and did not go back to the OR? Can you still use the modifier -73 if there is a dictated note?
Thanks
Tracy, CPC
Thanks
Tracy, CPC
Jamie Dezenzo
True Blue
http://www.beckersasc.com/asc-codin...-to-asc-and-physician-practice-modifiers.html
73 — Discontinued outpatient hospital/ASC procedure prior to the administration of anesthesia (A)
This modifier is appended to the CPT code for the intended procedure(s) to indicate that a procedure was terminated due to medical complications after the patient had been prepared for surgery and taken to the OR, but before anesthesia was induced. The ASC must have “expended significant resources” to charge for the scheduled procedures using this modifier, and the patient must be physically located in the OR or the procedure room where the procedure was to be performed in order to bill Medicare — the pre-op area is not allowed.
74 — Discontinued outpatient hospital/ASC procedure after the administration of anesthesia (A)
This modifier is appended to the CPT code for the intended procedure(s) to indicate that a procedure was terminated due to medical complications after anesthesia for the procedure was induced.
73 — Discontinued outpatient hospital/ASC procedure prior to the administration of anesthesia (A)
This modifier is appended to the CPT code for the intended procedure(s) to indicate that a procedure was terminated due to medical complications after the patient had been prepared for surgery and taken to the OR, but before anesthesia was induced. The ASC must have “expended significant resources” to charge for the scheduled procedures using this modifier, and the patient must be physically located in the OR or the procedure room where the procedure was to be performed in order to bill Medicare — the pre-op area is not allowed.
74 — Discontinued outpatient hospital/ASC procedure after the administration of anesthesia (A)
This modifier is appended to the CPT code for the intended procedure(s) to indicate that a procedure was terminated due to medical complications after anesthesia for the procedure was induced.