Wiki Cancelled Procedure - A question has come up

[rlmiller]

A question has come up about cancelled Colonoscopies. Patient had two unsucessful attempts at IV insertion. Patient decided not to have procedure. Physician wants to charge for the facility only since patient was checked in and an IV was attempted. Can we charge just a facility colonoscopy with a 73 modifier?
Thanks, Robin

 

[coachlang3]

Sure can!

 

[mcnaryk]

A question has come up about cancelled Colonoscopies. Patient had two unsucessful attempts at IV insertion. Patient decided not to have procedure. Physician wants to charge for the facility only since patient was checked in and an IV was attempted. Can we charge just a facility colonoscopy with a 73 modifier?
Thanks, Robin

I don't think so Robin-I think you'd have to code an appropriate level E/M and maybe the IV insertion, but you couldn't use the colonoscopy code since the procedure itself was never started. I don't have a lot of experience with the 73 modifier so maybe someone else can help us out here, but I think an E/M is the way to go here.

 

[rlmiller]

Thank you for the reponses. I am not sure an E&M code would be appropriate since the physician did not speak with the patient in pre-operative care, he was in another procedure.

 

[coachlang3]

Kristina, my thoughts on this is the procedure was started with the attempt of the IV. But it was stopped prior to the anesthesia being administered. In this case you would use a 73 modifier.

The patient was brought back and prepped for the procedure. They didn't enter the waiting room and turn around and say, "nah".

 

[capricew]

NO! you cannot bill that. In order to bill the discontinued colonoscopy for the facility
1) the patient has to have been in the procedure room in which the procedure was going to take place. If they were in the procedure room when the decision was made to cancel the procedure and anesthesia had not been administered then you bill the intended colonoscopy code (ie 45378) with a modifier 73
Or
2) if the patient was in the procedure room in which the procedure was to take place and the decision was made to cancel the procedure after anesthesia had been administered then you would bill the intended colonoscopy code with a modifier 74

You cannot bill at all if the decision to cancel the procedure was made in the pre-op area prior to the patient being taken to the procedure room. If you are going to bill scenario 1 or 2 make sure the physician dictates an op note indicating when the decision made to cancel. It sounds to me as though the patient made the decision, so if he was in the procedure room at the time the decision was made, then whatever colonoscopy code you intended to do would be appropriate to bill for the facility with a modifer 73.