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.
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