Discontinued Services

Billing and Reimbursement
Policy Number: RP-X-006

Last Updated: Sept. 29, 2022


When a physician or other qualified health care professional elects to terminate a surgical or diagnostic procedure due to extenuating circumstances, the service can be identified by appending modifier 53 to the procedure code. The reporting modifier 53 signifies the procedure was started but discontinued. Blue Cross and Blue Shield of Nebraska reimbursement for professional discontinued procedures is reduced by 50% of the allowable unmodified amount. Multiple procedure reductions still apply when applicable.  


When procedures are discontinued in an ASC or hospital outpatient setting, or when the physician terminates a surgical or diagnostic procedure after the administration of anesthesia, modifier 74 should be appended to indicate the service was started but terminated. Report the usual procedure code with modifier 74.