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Orthopedic Coding Alert

Modifier Myths:

Dispel The Common Myths About Modifier 22

Published on Mon May 09, 2011

You can avoid an audit by not taking the modifier 22 for grantedYou may read through an operative note to learn that the repair of a ligament in the knee was challenging due to presence of scar tissue or the graft was difficult to work or due to morbid obesity. Your first thought may be to turn to modifier 22 (Increased procedural services) to reflect the extra work, but there's a hitch: Overuse of this modifier can cause scrutiny from your payers or even the Office of the Inspector General (OIG). Read on for advice on when you can appropriately append modifier 22 and steer clear of OIG scrutiny.How it works: When a 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 [...]
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