Modifier:
Case Study: Shed Light On The Purpose Of Modifier 22
Published on Tue Apr 19, 2011
Tip: Details -- or the lack of it -- on physician's notes can make or break your claim.If you overuse modifier 22 (Increased procedural services) you may face increased scrutiny from your payers or even the Office of Inspector General (OIG). But if you avoid the modifier entirely or use minimally, you're likely missing out on reimbursement your otolaryngologist deserves. Additionally, if and when the modifier 22 is used, it is the documentation that will hold the pillars that support the case for additional payment.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 look to modifier 22. Modifier 22 represents those extenuating circumstances that do not merit the use of an additional or alternative CPT code but instead [...]