Neurosurgery Coding Alert

Do expect to produce a copy of the operative report upon payer request.

Do prepare a separate page with your claim that explains, in clear language, why the service was especially difficult or time-consuming.

Do compare the procedure to which you are appending modifier 22 to a typical procedure of the same type to better demonstrate to the payer the procedure's "increased"nature.

Do use critical care codes instead of modifier 22 when appropriate.

Do append modifier 22 to assistant-at-surgery procedures, if warranted.

Don-t append modifier 22 to secondary procedures.

Don-t use modifier 22 for re-operations or evaluation and management visits.

Don-t assume lysis of average adhesions merits modifier 22.

Don-t report modifier 22 simply because the physician performs a procedure via a lesser-preferred approach.

Don-t substitute an unlisted-procedure code for modifier 22 to avoid carrier denials.