Anesthesia Coding Alert

Question: We know we can charge extra units for anesthesia procedures coded with modifier -22. What are the guidelines, and what range of units is appropriate?

Maryland Subscriber

Answer: Modifier -22 (unusual procedural services) does not usually carry a specific unit value; instead, it is rated according to the reasons for its use. Many practices generally allow one to five units for modifier -22. For example, some groups add three units when billing fiberoptic intubation with modifier -22 appended and might add more units when appending -22 to higher-level procedures such as vascular bypass surgery.

Billing with modifier -22 is an individual practice choice. Generally, for modifier -22, practices calculate the fee to include units or dollar amount. However, many carriers will not reimburse additional charges for modifier -22 until after youve appealed the payment and provided the rationale for its use.