Radiology Question for the Week of April 7, 2025

Question:

Under what circumstances should modifier 73 be used when reporting a canceled outpatient procedure?

Answer:

When a procedure is scheduled and subsequently canceled due to extenuating circumstances or those that threaten the well-being of the patient, the intended service that is prepared for but cancelled prior to the administration of anesthesia can be reported by its usual procedure number and the addition of modifier 73. • Modifier 73 is for hospital outpatient/ASC use only. Coding Example:
A patient presents for a biopsy of a lesion within her right breast. She is positioned on the stereotactic table and prepped for the procedure. Prior to the physician’s administration of anesthesia, the patient becomes ill and is unable to continue with the procedure. The physician decides to discontinue the procedure due to extenuating circumstances surrounding the patient. The facility should code and bill code 19081-73. Modifier 73 identifies to the payer that the performing physician discontinued the procedure prior to 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.