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I know that you can add an 22 modifier for excessive time for a colonoscopy but how about multiple polyps being removed. If you can amend a 22 modifier for multiple polyps, how many polyps constitute this?
There is no threshhold for number of polyps or time. A detailed procedure report is the key factor. The report is used by a claims examiner to determine any extra reimbursement. You may want to instruct your physicians to determine his/her own threshholds and document very specific details when that threshhold is reached. Modifier 22 can be when when any factors make the procedure more difficult. Document to support the definition of modifier 22: when the work required to provide a service is SUBSTANTIALLY GREATER than typically required. (My emphasis).