tci General Surgery Coding Alert - 2006 Issue 4

READER QUESTIONS: Decide Between 22 and Unlisted-Procedure Codes

Question: How should I determine when to report a specific CPT code with modifier 22 rather than an unlisted-procedure code? For instance, our surgeon asks us to report procedures that take extra time and effort with an unlisted-procedure code so he can better explain what he did. But I think we should be submitting the procedure code with modifier 22.Pennsylvania Subscriber Answer: If CPT provides a code that properly describes a procedure, you should report that specific code. If the physician documents significant additional time or effort to complete the procedure, you may append modifier 22 (Unusual procedural...

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