tci Medicare Compliance & Reimbursement - 2006 Issue 34

BILLING: Warning--Don't Use Modifier 22 Unless You Can Show Extra Work

It's not enough to document previous procedure.Heads up: A clarification of modifiers 22 and 51 could be coming within the next year--and it's not too soon to prepare. The American Medical Association's CPT Editorial Panel discussed these modifiers at the panel's June meeting in Las Vegas, and they're on the agenda again for October's Washington, D.C. meeting. According to observers, the panel wants to clarify the instructions for when you should use both modifiers.The problem: The 22 modifier (Unusual procedural services), in particular, is a challenge for many practices, says Maxine Lewis with Medical Coding Reimbursement...

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