tci General Surgery Coding Alert - 2008 Issue 7

Meet 3 Requirements for Modifier 22 Success

Provide a comparison to defend additional reimbursement You probably already know that modifier 22 can raise reimbursement if your surgeon documents a greater-than-usual effort during a surgical service. To ensure success, however, surgeons and (especially) coders must also exert a special effort outside of the operating room. Here's what insurers demand before they-ll authorize additional payments for claims with modifier 22 (Increased procedural services). Requirement 1: Apply Sparingly Recognize that truly "increased" circumstances will occur in only a small minority of cases, says Lynn Anderanin, CPC, senior coding consultant for Health Info Services in Park Ridge, Ill.CMS guidelines...

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