Wiki 22 modifier

[tpontillo]

Does anyone have a sample op report that I can show my doctors as to what they need to report when they add a 22 modifier? I have a doctor that adds a 22 modifier to a colonoscopy and doesnt explain why? he just states it takes an extraordinary amount of time spent removing and retrieving they polyp. I have told him that he needs to specify how much time it took him also and he is not giving me this info. Thanks for any info

 

[jjhamer1]

Your doc definitely needs to specify time spent during the procedure, and also any/all complications thereof.

In my general surgery coding, periodically my surgeons may spend in upwards of 1 1/2 hours taking down abdominal adhesions, in order to accomplish the intended procedure.
As Modifier 22 reads:
Increased Procedural Services: When the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code.
Documentation must support the substantial additional work and the reason tor the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required).

 

[JDV7980]

No, sorry, no sample op note...but I agree with jjhamer1 "Documentation must support the substantial additional work and the reason tor the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required)."

If he is not documenting this info... He should not report modifier 22. Isn't sad when they can be reimbursed for all their hard work but they refuse to document?! I feel your pain.