Internal Medicine Coding Alert

Question: One of my physicians wants to charge more for a 95024 because he ordered it "stat." Should I append modifier 22 to this code?

Nebraska Subscriber

Answer: No. Ordering a test "stat" does not fall under modifier 22's (Increased procedural service) definition. "Stat" indicates only that your physician needs the results quickly. Your physician cannot charge extra for having the result of 95024 (Intracutaneous [intradermal] tests with allergenic extracts, immediate type reaction, including test interpretation and report by a physician, specify number of tests) done quickly You may append modifier 22 only when the service(s) your physician provides is "substantially greater than typically required," according to CPT's Appendix A. To support using this modifier, your physician's documentation must support the "substantial additional work" and must list the reasons why the doctor had to work harder, such as increased intensity or added time.