Wiki Surgical Approach Procedures

[lovemesomecodes]

We have a question on surgical global packaged procedures inclusive to "approach" procedures. We had a case where patient had a pituitary tumor removal. However during the approach it was found the tumor invaded several other structures and additional excisions were performed during the approach including pathological testing and margin identification etc. Even though these areas were in the same path as the "approach", would these not be seperately billable services? I remember reading information on this past but am unable to locate the documentation now. If so where may we find supporting documentation/coding guidelines for this? Thanks!

 

[Michele Hannon]

Consider appending modifier -22 Increased Procedural Service.
When the usual work to perform a procedure is significantly greater than typically required.
You will need to submit the operative report (detailing the additional work and the reason for it, technical difficulty and severity of the patient's condition) with the claim.