Wiki HELP ME PLEASE modifier 74 discontinued surgery

[linhtran]

Would you bill the insurance for a discontinued cataract surgery? Would it vary to what insurance the patient have? And would you bill with modifier 74 to both the professional claim and facility claim? No incision was made. Patient was prepped and anesthesia was given. Patient had a reaction to the ASA meds.

 

[mitchellde]

Yes the facility will use the 74 modifier and the physician will use the 53 modifier. Also you will need a secondary dx code from the V64 category to show the pateint reaction to the meds. There is reimbursement to both the facility and the physician so it is necessary to bill this.