tci Part B Insider - 2004 Issue 42

Slash Denials On Modifier -22 And Unlisted Procedure Claims With These 4 Tips

Documentation is key to reimbursement, but first you need to know when - and when not - to append modifier -22 Most coders are no stranger to denied claims with unlisted procedures or modifier -22, but you can secure payment on the first try by simply knowing what documentation to attach.   When your physician's efforts during a procedure go beyond the usual description for the procedure code, you have two choices: use an unlisted procedure code or append modifier -22 (Unusual procedural services). Deciding which coding route to take is your first challenge when faced with this situation...

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