Question:

We attempted a stereotactic breast biopsy, and the patient fainted, so the biopsy was canceled for the day. Do we charge for a stereotactic biopsy with supplies since it was attempted or a unilateral diagnostic mammogram since only images were obtained? The biopsy is rescheduled for a second attempt with sedation.

Answer:

It depends on payer guidelines and how much of the procedure was actually performed.

If billing for the hospital and to Medicare, and the patient was brought to the procedure room and prepped prior to the procedure being canceled, you could bill the scheduled procedure with modifier 73 (no anesthesia/sedation given), or 74 (anesthesia/sedation given or procedure started). If you only performed the initial images and had not prepped the patient yet, then code the initial images.


This question was answered in an edition of our Radiology Compliance Manager. For more hot topics relating to radiology services, please view our store, or call us at 1.800.252.1578 ext. 2.

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