AHA Coding Clinic® for HCPCS - 2016 Issue 1

Appropriate use of modifiers for discontinued services under the OPPS

The Central Office on HCPCS continues to receive requests for clarification regarding the use of discontinued modifiers under the outpatient prospective payment system (OPPS). Therefore we are publishing a recap of the reporting guidance on the use of modifiers for discontinued services under the OPPS. This information was previously published in AHA’s Coding Clinic for HCPCS, Third Quarter 2007. To provide clarity, this article will address the differences between a “failed or unsuccessful procedure” and a procedure that was discontinued. Failed/unsuccessful procedure When a procedure is considered to have “failed” or stated as “unsuccessful” this...

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