Wiki Canceled unlisted procedures

[yvalerio]

Hello everyone, this is my first time posting a question and I hope I do this right.
A patient received anesthesia for a dental procedure CRNA canceled the procedure due to patient having sinus tachycardia. Typically we would code the procedure and add the appropriate modifier, in this case it would be modifier 74. Since the CPT code is an unlisted CPT code modifiers are not appropriate. What would the recommendation be: to code the procedure or not code the procedure since we cannot add a modifier?

Thank you,
Yolanda V

 

[csperoni]

Since you would typically use -74, I will assume you are billing for the facility. Well, since you would typically bill & be paid for a procedure that is cancelled after anesthesia, I don't see any reason why you shouldn't bill & be paid for this.
Since unlisted codes don't have a fee schedule, and reimbursement is based on the information you provide (at least for physician unlisted claims they are), I would suggest to still bill the unlisted, and in your letter/documentation, include that the procedure was cancelled after anesthesia.
This would not be a claim I would expect to get paid first go around.
Just my 2 cents.

 

[yvalerio]

Thank you for your help.