tci General Surgery Coding Alert - 2003 Issue 9

Reader Question: Choose Your Coding Poison Based on Documentation

Question: How should I decide whether managing excessive bleeding that requires extra physician time and effort during a procedure warrants the use of modifier -22 or a critical care code? Florida Subscriber Answer: Review of documentation is vital for coding  the control of bleeding. Forget about modifier -22 if bleeding complicates an E/M service. You can append modifier -22 only to surgical CPT codes. Usually, you use modifier -22 because of excessive bleeding that is a direct result of the procedure the physician is performing. Circumstances definitely exist in which a critical care code is more appropriate...

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