Wiki Modifier 22 for 17111, 40 lesions

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JesseL

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Does treating 40 lesions allow reason enough for me to bill modifier 22 along with 17111 since this is way more than 15 lesions?

Has anyone ever had success with this modifier?
 
Modifier 22 for 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 for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). Note: This modifier should not be appended to an E/M service."

Also see this for some good information: http://www.wpsmedicare.com/j8macpartb/resources/modifiers/modifier-22.shtml
 
MarcusM said:
Modifier 22 for 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 for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). Note: This modifier should not be appended to an E/M service."

Also see this for some good information: http://www.wpsmedicare.com/j8macpartb/resources/modifiers/modifier-22.shtml
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Thanks, I know of the definition already, I'm asking is what I asked above considered substantial "additional work" to use modifier 22.

The Dr treated 40 warts because theses 40 warts on the patients hands. That statement alone should support how severe the problem is? She's using the cryo gun on all 40 so that takes a lot of extra time. But do payors consider this reasonable to use modifier 22?
 
Hi Jesse,

As per the description of this CPT 17111, more than 15 lesion (i-e any number of lesion) will be coded as 17111 only (without 22 modifier) Moreover there is no complexity line based upon the number of lesions treated, to use modifier 22. So I feel that it doesn't require modifier 22
 
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