tci Part B Insider - 2004 Issue 16

NOC Or -22: Send Letter, Documentation

When you're billing with the -22 modifier or a Not Otherwise Classified (NOC) code, you need to explain to the carrier what happened and the reason why you're seeking extra reimbursement.  WPS Medicare Administrators says it can't automate the processing of claims with NOC codes or the -22 modifier, because there are no consistent or standardized payment criteria which it can apply. Thus, the carrier suspends these claims for manual review by a human. This person will want to see an operative note or a procedure report. "The minimum you have to send is an op note,"...

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