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Aborted Cryoablation d/t hypotension under GA, limited CT w/wo contrast

Date: Feb 25, 2019

Question:

We found conflicting guidance on when to use modifier -74. See procedure below: "GA initiated. Initial limited CT scan of the abdomen was initially performed without intravenous contrast. The known left renal lesion was identified given internal linear low-attenuation. However, the complete extent of the lesion was not confidently visualized. Therefore, the patient was given 80 mL of Isovue-300 intravenous contrast and a repeat acquisition of the abdomen was obtained. This better delineated the small 1-1.2 cm enhancing lesion arising from the posterior aspect of the superior left renal pole. The left flank was prepped and draped in the usual sterile fashion. At this time, an open window to access in the lesion was identified. However, the patient began to experience hypotension, which became difficult to control for the anesthesiology service. Given the nonemergent/nonurgent nature of the procedure, the procedure was aborted prior to introducing the ablation probe or biopsy device." Is this considered an elective cancellation? If yes, we've coded 76380.

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