Part B Insider - 2003 Issue 1
You Be the Coder: Use Modifier -22 for Complications
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Article Overview
This coding article explains a scenario involving added work due to prior surgical complications and places it in the context of CPT and CMS policy changes. It is useful for coders, billing staff, and compliance professionals who need to understand how the article frames modifier guidance, the history of relevant policy changes, and the types of repeat or revision procedures discussed.
Why This Topic Matters
Situations involving prior surgery can affect how a procedure is reported and supported in documentation. The article helps readers understand the policy background and the general circumstances that make this topic relevant to accurate physician coding and compliance review.
Article Sections
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Question
Introduces a coding scenario about added work associated with prior surgery and asks how the situation should be reported.
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Answer
Summarizes the article’s guidance and places the issue in the context of CPT modifier history and related CMS policy developments.
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CMS decision and implications for repeat procedures
Discusses the CMS response to the CPT modifier change and the article’s broader discussion of revision or re-exploration procedures and altered surgical fields.
What You Will Learn
- How the article frames reporting additional work related to prior surgery
- How the discussion relates to CPT and CMS policy history
- What types of repeat or revision procedures are referenced in the article
- Why documentation is discussed as part of the scenario
Who Should Read This
- Medical coders
- Coding educators
- Billing professionals
- Compliance staff
- Physician practices
Codes Discussed
Code Ranges Discussed
Modifiers Discussed
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