tci General Surgery Coding Alert - 2003 Issue 6

READER QUESTION: Significant Additional Work Warrants -22

Question: If the physician spends an additional 30 minutes lysing adhesions during a laparoscopic chole-cystectomy, may I append modifier -22? Illinois SubscriberAnswer: CPT guidelines for using modifier -22 (Unusual procedural services) are maddeningly imprecise, stating only, "When the service(s) provided is greater than that usually required for the listed procedure, it may be identified by adding modifier -22." Remember that relative value levels for CPT codes are based on the median level of difficulty for a given procedure. That is, the time and work required for any procedure will vary from instance to instance, but payment remains constant...

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