tci Part B Insider - 2004 Issue 16

Unlisted Procedures: NOC Versus -22 Modifier: Controversy And Judgment Calls

We'll show you the "most correct" code for every situation If you're trying to decide between using the -22 modifier and a Not Otherwise Classified (NOC) code for extra work your physician performed, there are other considerations besides reimbursement. For one thing, there's your duty to use the most accurate code possible.   "You're not supposed to use an existing code to fit a procedure that's different even if it's close," says Jean Stoner, manager of coding operations for CodeRyte in Bethesda, MD. CPT guidelines tell providers not to try to squeeze a procedure into a code that...

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