tci General Surgery Coding Alert - 2004 Issue 2

You Be the Coder: Modifier -22 or Unlisted-Procedure Code?

Question: Our surgeon asks us to report procedures that take extra time and effort with an unlisted-procedure code so he can better explain what he did and why it didn't exactly fall under a CPT code. He also says that the payer will have to read the operative report, so there is a better chance for reimbursement. I think we should be submitting the procedure code with modifier -22. Who's right?New Jersey SubscriberAnswer: You can adopt this new rule of thumb: Don't use an unlisted-procedure code instead of modifier -22 (Unusual procedural services) to report additional time and...

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