Results 1 to 4 of 4

Billing preop services when surgery cancelled

  1. Question Billing preop services when surgery cancelled
    Exam Training Packages
    If surgery is cancelled after the pt is admitted to the preop area, can supplies used and drugs administered be billed? Are the rules different for Medicare vs. Commercial payers on this question?

  2. #2
    Default
    isn't modifier 53 used for that kind of scenario? since supplies and drugs are bundled to whatever cancelled procedure is reported.

  3. #3
    Location
    Columbia, MO
    Posts
    12,570
    Default
    Quote Originally Posted by medcoder9 View Post
    isn't modifier 53 used for that kind of scenario? since supplies and drugs are bundled to whatever canceled procedure is reported.
    Modifier 53 can be used but only if the patient is in the room where the procedure is to be performed when the decision to cancel is made. So if the patient never leaves the preop area then no you cannot bill the service with a 53.

    Debra A. Mitchell, MSPH, CPC-H

  4. #4
    Location
    Columbia, MO
    Posts
    12,570
    Default
    Quote Originally Posted by resource View Post
    If surgery is cancelled after the pt is admitted to the preop area, can supplies used and drugs administered be billed? Are the rules different for Medicare vs. Commercial payers on this question?
    If you are billing for the physician then no since the supplies and drugs were expended by the facility. If you are the facility then you might be able to apply a facility charge dependening on what your facility assessment tool allows for a visit. If the patient never left preop then you cannot use either the 73 or 74 modifier as the patient must be in the room where the procedure is to be performed when the decision to cancel occurred, just like the physician requirement for the 53. Also waht is the reason for the cancelation?

    Debra A. Mitchell, MSPH, CPC-H

Similar Threads

  1. Billing preop for canceled surgery
    By kellyg in forum OB/GYN
    Replies: 2
    Last Post: 07-02-2014, 02:52 PM
  2. PreOp visits after the decision for surgery
    By excelortho in forum Orthopaedics
    Replies: 3
    Last Post: 11-15-2012, 03:14 PM
  3. Preop before surgery
    By cknighton@fchn.org in forum E/M
    Replies: 1
    Last Post: 09-04-2012, 11:21 AM
  4. Anesthesia services cancelled.
    By dgiretto in forum Anesthesia
    Replies: 4
    Last Post: 04-01-2009, 04:28 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •  
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?

Login

Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.