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Modifier 73

  1. #1
    Default Modifier 73
    Medical Coding Books
    Can we (ASC) bill for a cancelled procedure where they have administered a femoral block (64447), and then found out the patient had an infection, before going to the OR? Patient had to go to PACU for recovery because of the block. Patient will be rescheduled for next week. I do not have dictation yet...

  2. #2
    Columbia, MO
    The description for the 73 states the patient must be in the room where the procedure is to be performed when the decision to discontinue is made use the 73 if anesthesia has not been administered and 74 if it has, also you will need to use as a secondary dx code a code from the V64 catergory. Your documentation will be an op/procedure note dictating the need to discontinue and the location of the decision. If the patient was not already in the OR room, then you may not report the procedure discontinued.

  3. #3
    The patient was moved from pre-op to the Procedure Room, where they do all other nerve blocks for Pain Management. That's where they did the block, but not yet to OR. I have coded 73/74 several times in the past, but this is a tricky one for me.

  4. #4
    Columbia, MO
    So I would say no then since the procedure was to be done in the OR... code for the block instead.

  5. #5
    Thanks Mitchell! That's what I was thinking, just needed confirmation that my sleepy head is working!

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