decisionhealth Newsletters, Coder Pink Sheets - 2009 Issue 1 (January)
Extra time or effort justify modifier 22
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Article Overview
This article discusses the use of modifier 22 in obstetric and gynecologic coding, with emphasis on when extra work may justify reporting it and what documentation practices are typically expected. It is aimed at coders, billers, and physician practices that want to understand the broad compliance and reimbursement considerations involved in supporting claims that a service required substantially more effort than usual.
Why This Topic Matters
Modifier 22 can affect claim review and reimbursement, so accurate documentation and clear communication between the coder and physician are important when a procedure required materially more work than expected.
What You Will Learn
- The general purpose of modifier 22 in procedural coding
- Situations that may prompt consideration of increased procedural services
- The importance of documentation in supporting added work
- Common types of information payers may expect with the claim
- How coding staff can coordinate with physicians when operative notes need clarification
Who Should Read This
- ObGyn practices
- Medical coders
- Medical billers
- Physicians
- Practice managers
Codes Discussed
Modifiers Discussed
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