Modifier 74- Discontinued Outpatient Hospital/ASC Procedure After Administration of Anesthesia

Modifier 74 is used when an outpatient hospital or ambulatory surgery center (ASC) procedure is discontinued after anesthesia has been administered or after the procedure has begun due to extenuating circumstances or patient safety concerns.

What is Modifier 74?

Modifier 74 is reported by outpatient hospitals and ambulatory surgery centers (ASCs) when a procedure is discontinued after anesthesia has been administered or after the procedure has begun. It allows facilities to report services and resources already provided when the procedure must be terminated because continuing would place the patient's health or safety at risk. Modifier 74 is intended for facility claims only.

When to Use Modifier 74

• Anesthesia has already been administered.

• The procedure has started but cannot be completed.

• The procedure is discontinued because of patient safety or extenuating circumstances.

• The claim is submitted by an outpatient hospital or ASC.

Billing Example

An outpatient hospital begins a colonoscopy after moderate sedation has been administered. During the procedure, the patient develops a serious cardiac arrhythmia requiring immediate termination of the procedure. The facility reports the intended procedure with Modifier 74.

Documentation Tips

• Document why the procedure was discontinued.

• Record that anesthesia had been administered or the procedure had begun.

• Include operative and anesthesia records.

• Clearly describe the circumstances leading to termination.

Common Denial Reasons

• Documentation does not support discontinuation after anesthesia.

• Procedure was canceled before anesthesia was administered.

• Procedure was canceled for non-medical reasons.

• Modifier reported on an ineligible claim type.

Related Modifiers

Modifier 53

Modifier 73

Modifier 52

Home > All Modifiers > Surgical Modifiers > Modifier 74