Medicare Compliance & Reimbursement - 2021 Issue 3
Reader Questions: Hone Modifier 22 Skills
Subscribe or sign in to view the full article.
Article Overview
This article addresses a reader question about modifier 22 and discusses the general documentation themes that can affect whether a claim is viewed as supporting increased procedural service. It is intended for coding professionals and physicians who need to understand the broad factors reviewers expect to see, along with common caution points for documentation and reporting.
Why This Topic Matters
Modifier 22 can draw special payer scrutiny, so clear documentation of unusual work, complexity, and the reasons for increased service can affect claim review. The article helps readers understand the kinds of supporting details that matter without replacing the need to consult payer policy and full coding guidance.
Article Sections
-
Question
A reader asks about the threshold for considering modifier 22 and whether time is the main factor.
-
Answer
The response discusses broad considerations for increased procedural service, the importance of documentation, and general cautions about where the modifier should not be used.
-
Coder tip
A short practical note summarizes how payer expectations may influence documentation style and the types of supporting details reviewers may look for.
What You Will Learn
- The general purpose of modifier 22 in coding review contexts
- Broad documentation elements that may be relevant when increased procedural service is considered
- Why reviewers may look for more than elapsed time when assessing unusual procedure work
- How payer expectations can influence the way supporting documentation is framed
Who Should Read This
- Medical coders
- Coding auditors
- Physician practices
- Surgeons
- Revenue cycle staff
Modifiers Discussed
Subscribe or sign in to view the full article.
Quick, Current, Complete - www.findacode.com