Advanced Search

Pediatric Coding Alert

You Be the Expert:

Choose Your Coding Poison Based on Documentation

Published on Tue Jul 01, 2003

Question: How should I decide whether managing excessive bleeding that requires extra physician time and effort during a procedure warrants the use of modifier -22 or a critical care code?

Florida Subscriber

Answer: First and foremost, you can forget about using modifier -22 (Unusual procedural services) if bleeding complicates an E/M service. Modifier -22 can only be appended to surgical CPT Codes . Modifier -22 is used most commonly because of excessive bleeding when the bleeding is a direct result of the procedure the physician is performing.

You may need to use a critical care code when the physician is controlling bleeding for a critically ill patient whose condition is potentially life-threatening if the bleeding continues.

  You Be the Expert reviewed by Richard Tuck, MD, FAAP, a practicing pediatrician with Primecare Pediatrics of Zanesville, Ohio.
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in your eNewsletter
  • 6 annual AAPC-approved CEUs*
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more
*CEUs available with select eNewsletters.

Other Articles in this issue of

Pediatric Coding Alert

View All