Wiki 22 modifier with SVT ablations

[gkahler99]

I recently had two different cases where I believe a 22 modifier should be used, but I'm not sure what is normal for ablations. In two different cases multiple applications of RF energy were applied in order to obtain junctional rhythm - more than 35 applications in each case. I queried the provider to find out what was "normal" and he said 1-2. The documentation has never before stated how many ablations were done, so before I submit the charges I was wondering if anyone else has added the 22 modifier to an SVT ablation and if you think this qualifies. Thanks in advance for the assistance.

 

[twizzle]

I recently had two different cases where I believe a 22 modifier should be used, but I'm not sure what is normal for ablations. In two different cases multiple applications of RF energy were applied in order to obtain junctional rhythm - more than 35 applications in each case. I queried the provider to find out what was "normal" and he said 1-2. The documentation has never before stated how many ablations were done, so before I submit the charges I was wondering if anyone else has added the 22 modifier to an SVT ablation and if you think this qualifies. Thanks in advance for the assistance.

I think the fact that multiple applications of energy were required to ablate the SVT is not grounds alone for using the 22 modifier.
The procedure would have to be documented by the provider as being abnormally difficult(and the reasons why) and taking way more time than is usual. Multiple applications of energy, although taking a bit longer than usual, wouldn't qualify. Any intra-operative complications could also be documented and used, but at the end of the day the provider is the only one who can say why the ablation should merit extra reimbursement.

 

[gkahler99]

I think the fact that multiple applications of energy were required to ablate the SVT is not grounds alone for using the 22 modifier.
The procedure would have to be documented by the provider as being abnormally difficult(and the reasons why) and taking way more time than is usual. Multiple applications of energy, although taking a bit longer than usual, wouldn't qualify. Any intra-operative complications could also be documented and used, but at the end of the day the provider is the only one who can say why the ablation should merit extra reimbursement.

Thank you so much! One of the cases involved other complications and one did not. It helps to hear a different opinion since I was doubting myself.