Neurosurgery Coding Alert

Appending modifier 22 for increased procedural services may increase the chances of an audit.When a neurosurgical procedure requires significant additional time or effort that falls outside the normal range 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. Extended surgical services are not uncommon in neurosurgery and modifier 22 represents them best especially without the use of an additional or alternative CPT® code and also raises the reimbursement for a given procedure. Your surgeon may have taken extra time during an osteotomy as the spine may have a congenital deformity complicating the procedure. But beware the liberal use which can lead to an audit and underuse which can compromise reimbursement. Acquaint yourself with the following three myths -- and the realities -- to ensure you don't misunderstand and wrongly code modifier 22. [...]