Increased Services:
Modifier 22 Offers Reimbursement Opportunities If You Overcome 3 Myths
Published on Fri May 13, 2011
Don't fall for these common body habitus, time, and fee traps.If you overuse modifier 22 (Increased procedural services), you may face increased scrutiny from your payers or even the Office of Inspector General (OIG). But if you avoid the modifier entirely, you're likely missing out on reimbursement your cardiologist deserves.How it works: When a procedure requires significant additional time or effort that falls outside the normal effort of services described by a particular CPT® code -- and no other CPT® code better describes the work involved in the procedure -- you should look to modifier 22. Modifier 22 represents those extenuating circumstances that do not merit the use of an additional or alternative CPT® code but do land outside the norm and may support added reimbursement for a given procedure. Take a look at these three myths -- and the realities -- to ensure you don't fall victim to these modifier 22 trouble spots.Myth [...]