tci Part B Insider - 2011 Issue 11

Part B Coding Coach: Do Your Services Warrant Modifier 22? Find the Truth Behind These 3 Myths Before You Answer

If you assume you can always append modifier 22 in certain situations, you're headed toward an audit.If you overuse modifier 22 (Increased procedural services) you may face increased scrutiny from your payers or even the Office of Inspector General (OIG). But if you avoid the modifier entirely, you're likely missing out on reimbursement your physician deserves.How it works: When a procedure requires significant additional time or effort that falls outside the normal range of services described by a particular CPT code -- and no other CPT code better describes the work involved in the procedure -- you...

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