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Surgical procedure in SDC stopped before initial incision

Donna Posted Tue 19th of February, 2013 19:21:35 PM

Our Dr was set to do cataract surgery on a patient with corneal opacity. After the patient was prepped and blocked, our Dr decided the opacity was too severe and the anterior capsule could not be viewed. He decided not to do surgery and did not even start the procedure. Can I bill for anything for the physician?

SuperCoder Answered Wed 20th of February, 2013 07:27:36 AM

You can report the procedure with Modifier 74, Official description of Modifier 74 is :
"Discontinued Out-Patient Hospital/Ambulatory Surgery Center (ASC) Procedure After Administration of Anesthesia: Due to extenuating circumstances or those that threaten the well being of the patient, the physician may terminate a surgical or diagnostic procedure after the administration of anesthesia (local, regional block(s), general) or after the procedure was started (incision made, intubation started, scope inserted, etc). Under these circumstances, the procedure started but terminated can be reported by its usual procedure number and the addition of modifier 74. Note: The elective cancellation of a service prior to the administration of anesthesia and/or surgical preparation of the patient should not be reported. For physician reporting of a discontinued procedure, see modifier 53. "

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