73 - JE Part B
Modifier 73
Prior Discontinued Ambulatory Surgical Center (ASC) or Outpatient Hospital
Instructions
When a surgical or diagnostic procedure is discontinued, prior to anesthesia administration in outpatient hospital or ASC only, physician may terminate the procedure with 73 facility modifier
Correct Use
- Due to extenuating circumstances or threaten patient well-being
- Prior to procedure started/patient's surgical preparation (including sedation or taken to procedure room)
- Prior to administration of anesthesia (local, regional block or general)
- Under these circumstances, intended service is prepared, but canceled and reported by the usual procedure number
Incorrect Use
- Do not report elective cancellation of patient service prior to administration of anesthesia and/or surgical preparation
- Append 53 modifier for physician reporting of discontinued procedure
Claim Coding Example
Treatment Description | CPT/Modifier |
---|---|
Anesthesia for procedures on thoracic spine and cord; not otherwise specified | 00620 73 |
Reduced Billing by Percentage
Provider performs 60% of service and appends modifier 73.
Description | Amount |
---|---|
Medicare Physician Fee Schedule (MPFS) allowed | $200 |
Bill Reduced Amount ($200 x 60%) | $120 |
Note: Medicare recognizes that many providers use one standard fee schedule for all insurance carriers. Therefore, reducing the charge amount may differ from the example.
Resource
Last Updated Tue, 25 Oct 2022 14:55:23 +0000