Modifier 73 | Discontinued Outpatient Procedures Prior To Anesthesia Administration

Modifier 73 describes a discontinued outpatient hospital or ambulatory surgery center procedure before the administration of anesthesia.

1. What is modifier 73?

Modifier 73 indicates that a provider terminated a surgical or diagnostic procedure requiring anesthesia before administering anesthesia due to extenuating circumstances threatening the patient’s well-being.

2. When to use modifier 73?

Modifier 73 should only be used when a provider terminates a surgical or diagnostic procedure requiring anesthesia before administering anesthesia due to extenuating circumstances threatening the patient’s well-being.

In addition, it should not be used for elective cancellations of a service or procedure before anesthesia administration and/or surgical patient preparation.

3. Description

The official description of modifier 73 is “discontinued outpatient hospital/ambulatory surgery center (ASC) procedure prior to the administration of anesthesia.”

4. Examples

Examples of procedures that may require modifier 73 include a patient experiencing sudden chest pain or unexpected changes in blood pressure during preparation for a surgical or diagnostic procedure requiring anesthesia.

5. Documentation

To use modifier 73, the provider must document the extenuating circumstances that led to the termination of the procedure in the patient’s medical record.

The documentation should include the reason for the termination, the steps taken to prepare the patient for the procedure, and any other relevant information.

6. Billing

When billing for a discontinued procedure using modifier 73, the provider should append the modifier to the procedure code on the claim form. Medicare contractors apply a 50 percent payment reduction for cases that qualify and are reported with modifier 73. Check with other payers for guidance on reporting and reimbursement of canceled procedures.

7. Common mistakes

One common mistake that medical coders make when using modifier 73 is using it for elective cancellations of a service or procedure before anesthesia administration and/or surgical preparation of the patient.

To avoid this mistake, coders should ensure that the termination of the procedure was due to extenuating circumstances that threatened the patient’s well-being.

8. Other modifiers related to modifier 73

Other modifiers related to modifier 73 include modifier 53, used to indicate a discontinued procedure, and modifier 74, used to indicate that a procedure was terminated due to extenuating circumstances after the administration of anesthesia.

9. Tips

When using modifier 73, it is crucial to ensure that the documentation supports the use of the modifier and that the reason for the termination of the procedure is clearly stated. Additionally, medical coders should be familiar with other modifiers related to modifier 73 to ensure that the correct modifier is used in each situation.