Do you have any tips for applying modifer 74?
When a procedure is scheduled and subsequently cancelled due to extenuating circumstances or those that threaten the well-being of the patient, the intended service that is prepared for but cancelled after the administration of anesthesia can be reported by its usual procedure number and the addition of modifier 74. Modifier 74 is for hospital outpatient/ASC use only. Coding example: A patient presents for a biopsy of a lesion within her right breast. The patient is positioned on the stereotactic table and prepped for the procedure. The physician administers local anesthesia. After several passes with the needle, the physician is unable to obtain a usable biopsy sample. The physician decides to discontinue the procedure due to extenuating circumstances. The facility should code and bill code 19081-74. Modifier 74 identifies to the payer that the performing physician discontinued the procedure after the administration of anesthesia.
This question was answered in our Breast & Bone Density Procedure Coding Guide. For more hot topics relating to radiology services, please visit our store or call us at 1.800.252.1578, ext. 2.
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