tci General Surgery Coding Alert - 2003 Issue 9

Think You've Made Your Case for Modifier -22? Not if You Haven't Done These 5 Things

If you're submitting claims for unusual procedural services without first determining how you're going to defend them, chances are your case won't hold up with payers - unless you use this defense crafted by coding experts. "The careful and proper usage of modifier -22 (Unusual procedural services) can be an invaluable tool in obtaining additional reimbursement for surgical services," says Arlene Morrow, CPC, CMM, CMSCS, a coding specialist and consultant with AM Associates in Tampa, Fla. But coders, beware: Overuse of this modifier may be a red flag to carriers monitoring claims coded for the purpose of obtaining...

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