tci Part B Insider - 2013 Issue 11

Reader Question: Know How ASC Should Bill Elective Cancellation

Question: I know you shouldn’t report modifier 73 for elective cancellation of a procedure. How do you handle that situation from the ASC billing standpoint? Answer: You’re correct in saying that modifier 73 (Discontinued outpatient hospital/ambulatory surgery center [ASC] procedure prior to the administration of anesthesia) does not apply when the surgery is canceled because the patient decides (for whatever reason) to not go through with the procedure. Explanatory notes in CPT® state that modifier 73 applies when the surgeon cancels the procedure prior to anesthesia administration because of extenuating circumstances or because the patient’s wellbeing...

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