decisionhealth Newsletters, Part B News - 2014 Issue 6 (June)
Modifier 22 – Be prepared to show your work when you report increased services
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Article Overview
This article discusses the use of modifier 22 for increased procedural services and focuses on documentation expectations, payer policy variation, claim submission notes, and follow-up after submission. It is aimed at coders, compliance staff, and physicians who need to understand how carriers review claims and what kinds of supporting information are commonly requested. The content emphasizes general guidance from payers and compliance educators rather than a technical coding tutorial.
Why This Topic Matters
Modifier 22 can affect reimbursement and claim review, so accurate documentation and payer-specific submission practices are important for practices seeking proper payment and fewer denials.
What You Will Learn
- How the article frames documentation needs for increased procedural services
- Why payer policies and submission requirements should be checked before using the modifier
- What types of supporting information are generally discussed in relation to claim review
- How practices are advised to monitor responses after submission
Who Should Read This
- Physicians
- Medical coders
- Compliance auditors
- Practice managers
- Billing staff
Modifiers Discussed
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