Pulmonology Coding Alert
Modifier -22
North Carolina Subscriber
Answer: Modifier -60 was deleted in CPT 2001. Modifier -22 (unusual procedural services) should be appended to the bronchoscopy procedure code (31622-31656).
Modifier -22 indicates to the carrier that the service provided is greater than that usually provided. It is important to note that although Medicare recognizes this modifier, some managed care organizations and commercial carriers do not. You must file a paper claim and submit additional specific documentation to support your request for additional payment.
Because the service provided is greater than that incorporated in the code description, you may need to provide the carrier with the fee that you expect to be reimbursed, along with the percentage of time, e.g., 25 percent, that the procedure required beyond the usual time allotted for that procedure.
Pulmonology Coding Alert
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