73 - JE Part A

Prior Discontinued Ambulatory Surgical Center (ASC) or Outpatient Hospital

Instructions

Due to extenuating circumstances or circumstances that threaten the patient's well-being a surgical or diagnostic procedure can be discontinued, prior to anesthesia administration in an outpatient hospital or ASC only. A physician may bill for the intended procedure but report the discontinuation of the procedure using this modifier.

Correct Use

• Append if discontinuation occurred prior to procedure starting or prior to patient's surgical preparation (including sedation or taken to procedure room)
• Append if discontinuation occurred prior to administration of anesthesia (local, regional block or general)

Incorrect Use

• Do not append to service if cancellation is patient elective and made prior to administration of anesthesia and/or surgical preparation

Resource

• CMS Internet Only Manual (IOM), Publication 100-04, Medicare Claims Processing Manual, Chapter 4, Section 20.6.4