tci Part B Insider - 2003 Issue 28

Modifiers: Give Carriers a Comparable Procedure to Win Extra Reimbursement

Master modifiers -22 and -52 to get on top of abnormally big or small procedures No two procedures are the same, but Medicare offers us a one-size-fits-all coding system.   What should you do if your Physician Coder performs a procedure and it takes a lot more time - or a lot less time - than normal? You can use modifier -22 (Unusual procedural services) to indicate that the physician did much more than expected, or modifier -52 (Reduced services) if the physician did much less. But good luck getting Part B carriers to respond to those modifiers, especially...

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