AHA Coding Clinic® for HCPCS - 2007 Issue 4; FOR your INFORMATION
Interrupted procedures
OPPS FINAL RULE The following information was posted in the November 27, 2007, Outpatient Prospective Payment System (OPPS) final rule at www.cms.gov. Interrupted procedures Currently, when a procedure is interrupted after its initiation or the administration of anesthesia, hospitals append modifier 74 (Discontinued outpatient procedure after anesthesia administration) to the interrupted procedure. In addition, when a procedure requiring anesthesia is discontinued after the patient is prepared for the procedure and taken to the room where the procedure is to be performed, but before the administration of anesthesia, hospitals currently append modifier 73 (Discontinued outpatient procedure prior to...
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Article Overview
This article explains a CMS outpatient payment policy update from the November 27, 2007 OPPS final rule. It is aimed at hospital outpatient coding and billing staff, compliance teams, and revenue cycle professionals who need to understand the policy context for interrupted procedures, modifier reporting, and a related regulatory conforming change for CY 2008. The article focuses on general reporting circumstances for interrupted services and the OPPS policy setting in which they were discussed.
Why This Topic Matters
Interrupted outpatient procedures can affect how hospital services are reported under OPPS, so understanding the policy context helps reduce billing inconsistencies and support compliant charge capture. The article also notes a regulatory wording change that broadened the scope of the referenced hospital outpatient procedure language.
What You Will Learn
- How CMS addressed interrupted outpatient procedures in the OPPS final rule context
- The general hospital outpatient reporting scenarios discussed for interrupted services
- The regulatory background associated with the CY 2008 conforming change
- Which policy framework and modifier groupings were referenced in the article
Who Should Read This
- Hospital outpatient coders
- Outpatient billing staff
- Revenue cycle professionals
- Compliance teams
- Health information management professionals
Codes Discussed
Modifiers Discussed
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