Wiki Modifier 22

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I don't have my reference handy today. When I was taught to use modifier 22, it was reiterated that this only applied to the first line item (or highest RVU procedure) for that DOS.
 
speedy said:
Can modifier 22 be added to multiple codes on a multilpe procedure claim?
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If you have multiple procedures, a 22 modifier should not be required on ALL of them. Can you post an example of the codes? Usually just the highest level RVU procedure would get a 22 modifier, and then it must be clearly documented how and why the procedure was more than what is normally performed (eg, time, anatomy issues, complications, etc).
 
We have always been taught to use 22 on the highest RVU code as well. Also have always been told to send the OR along with a letter from the dr. explaining how much additional he expects to get paid and why this was more difficult than the normal case. Also good luck, I have never really had much luck getting paid additional on this except in very extreme cases.
 
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