Neurosurgery Coding Alert

Watch frequency and provide documentation to rationalize extra pay. Applying modifier 22 (Increased procedural services) can help increase reimbursement if your neurosurgeon documents a greater-than-usual effort during a surgical service. To ensure your claims' success, surgeons and coders must also exert a special effort outside of the operating room -- especially in terms of documentation. 1. Apply 22 Sparingly Payers won't accept a modifier 22 claim unless you can provide convincing evidence that the service or procedure was truly "out of the ordinary" and significantly more difficult or time-consuming than usual. Here's why: CPT codes describe a "range of services." In other words, although one procedure may go smoothly, the next procedure of the same type may take longer or prove to be more difficult. The fee schedule amounts assigned to individual codes assume that the "easy" and "hard" procedures will average out over time. In some cases, however, the surgery [...]