tci Part B Insider - 2007 Issue 35

MODIFIERS: Throw Out The 25-Percent Rule For Modifier 22

Beef up your documentation for the 59 modifierHeads up: The requirements for modifier 22 are becoming much stricter in January.Old rules: You use the 22 modifier when your physician provides a service that is -greater than that usually required for the listed procedure.- A report on the reason for the modifier -may also be appropriate.-New rules: Your physician's work must be -substantially greater than typically required.- And your documentation must support the -substantial additional work.- You also must list the reasons why the doctor had to work harder, such as increased intensity, added time...

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