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Outpatient Facility Coding Alert

Modifier Watch:
Remember Timing Is Everything When Choosing Between Modifiers 73 and 74

Procedure documentation should point you in the right direction for cancellation coding. Physicians have one set of modifiers to use when reporting canceled procedures, but you have different ones to consider as an ASC or hospital outpatient coder. Your key to reimbursement lies in the correct application of modifiers 73 (Discontinued outpatient hospital/ambulatory surgery center [ASC] procedure prior to the administration of anesthesia) and 74 (Discontinued outpatient procedure after anesthesia administration). Check Anesthesia Administration for Modifier 73 Your first step in making the right modifier choice is to verify when the procedure cancellation occurred. Modifier 73 is reserved for ASC and/or hospital outpatient reporting when the procedure is canceled after the patient is taken to the surgical area, but before anesthesia administration. "In the event that the physician must stop the procedure due to a medical complication or finding, the ASC will still collect a portion of their reimbursement if [...]

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