Modifier ‑74 indicates an outpatient hospital or ASC procedure that was discontinued after anesthesia was administered and after the procedure had begun. Use this modifier when anesthesia (local, regional, moderate sedation, or general) was given and the procedure was terminated after commencement (for example after incision, intubation, or scope insertion) because of extenuating circumstances or events threatening the patient’s well‑being. Modifier ‑74 was introduced to address the outpatient hospital/ASC context specifically and differs from modifier ‑53, which historically covered discontinued procedures but is more commonly used for physician partial performance in some contexts.

For facility billing (outpatient hospital or ASC), appending modifier ‑74 to the discontinued procedure code documents that anesthesia had been administered and the case was aborted after it had started. Practice‑based and forum consensus indicate the facility typically receives full payment for the discontinued procedure when reported with ‑74; however, reimbursement ultimately depends on payer policy and Medicare outpatient payment rules. For physician professional services, coding practices may differ (for example, providers sometimes report modifier ‑53 for partial performance), so ensure the facility and the physician use the appropriate modifier for their respective claims.

Documentation is essential: records must clearly state that anesthesia was administered, describe that the procedure had commenced (e.g., incision, scope insertion, intubation), and explain the reason for discontinuation (such as an adverse event or safety concern). Always verify payer‑specific and Medicare Administrative Contractor guidance before relying on expected reimbursement or modifier use, since actual payment determinations vary by payer and program.