tci Part B Insider - 2009 Issue 23

READER QUESTION: Factor in Range of Service When Coding Visit With Obese Patient

If you use modifier 22, make sure your documentation is crystal clear. Question: Recently, our surgeon performed spinal fusion (22630) on an extremely obese patient. The surgeon feels as though the patient's weight was a complicating factor in the surgery and subsequent recovery. Can we gain additional compensation for this, perhaps using modifier 22? Answer: You could possibly obtain additional reimbursement by appending modifier 22 (Increased procedural services) to 22630 (Arthrodesis, posterior interbody technique ...). You would have to provide the payer with a full and convincing argument as to why the patient's obesity substantially complicated the surgery and...

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