AHA Coding Clinic® for HCPCS - 2018 Issue 2; Clarifications

Clarification on the use of Modifier 52 versus Modifier 74

The Central Office on HCPCS continues to receive requests for clarification on the use of modifier 52, Reduced Services, versus modifier 74, Discontinued out-patient hospital/ambulatory surgery center (ASC) procedure after administration of anesthesia, for reduced services provided under Medicare OPPS. To assist in providing official guidance for the reporting of reduced services under Medicare OPPS, we are publishing instructions for the appropriate reporting of these modifiers, provided by CMS on December 22, 2016, in Transmittal 3685. This information can be found at www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/Downloads/R3685CP.pdf. These modifiers provide a way for hospitals to report and be paid for...

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