tci Medicare Compliance & Reimbursement - 2008 Issue 6

Coding Coach: Follow These 5 Rules To Modifier 22 Claim Success

You decide which services warrant the effort associated with modifier 22 Catch 22: If you're using modifier 22 on almost all of your surgical claims, you're headed for an audit. But if you're not using modifier 22 at all, you could be passing up ethical reimbursement increases.Did you know? In the past, some Medicare carriers have suggested that physicians should use modifier 22 (Increased procedural services) with fewer than 5 percent of all cases. In other words, you should always apply modifier 22 sparingly -- but that doesn't mean you should never use this modifier at all.Key:...

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