Can a facility bill for a cancelled procedure? 

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Source: Nicole Helfrich, Titan Health

Hospitals and ASCs can bill for surgical or diagnostic procedures cancelled by a physician due to extenuating circumstances including those that threaten the well-being of the patient. The CPT provides billing modifiers -73 and -74 for this purpose.

 

Modifier 73 – Use this modifier in conjunction with the primary procedure code when the procedure is cancelled subsequent to the patient’s surgical preparation but prior to administration of anesthesia.

 

Modifier 74 – Use this modifier in conjunction with the primary procedure code when the procedure is cancelled after administration of anesthesia or after the procedure is started.

 

Note: Elective cancellation of a service prior to the administration of anesthesia and/or surgical preparation of the patient should not be reported. For physician reporting of a discontinued procedure, use modifier -53.

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