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procedure not done after anesthesia

Lesia Posted Thu 24th of January, 2013 15:26:28 PM

A physician plans on doing an excision of lesion of the tongue but once the patient was under anesthe3sia, he couldn't see the lesion so he just examined the tongue. How would you code this? Would you code the intended procedure with modifier 74 or 52?

SuperCoder Answered Tue 29th of January, 2013 21:34:15 PM

I agree if performed in facility Modifier 74 is appropriate here.Modifier -74 is used by the facility to indicate that a surgical or diagnostic procedure requiring anesthesia was terminated after the induction of anesthesia or after the procedure was started (e.g., incision made, intubation started, scope inserted) due to extenuating circumstances or circumstances that threatened the well being of the patient. For purposes of billing for services furnished in the hospital outpatient department, anesthesia is defined to include local, regional block(s), moderate sedation/analgesia (“conscious sedation”), deep sedation/analgesia, and general anesthesia. This modifier code was created so that the costs incurred by the hospital to initiate the procedure (preparation of the patient, procedure room, recovery room) could be recognized for payment even though the procedure was discontinued prior to completion.

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