What documentation is needed for modifier 22?
When the modifier 22 is used, two separate documents will be required to support the claim: An operative report; and. A separate statement indicating how the service differs from the usual.
Can modifier 22 be appended to add on codes?
Modifier 22 is for physician reporting only (facilities may not report modifier 22), and should not be appended to evaluation and management (E/M) codes, according to CPT® guidelines.
Can modifier 22 be used for assistant surgeon?
Assistant surgery services may be submitted with the modifier -22 as secondary to the appropriate surgical assist modifier (-81, 82 or –AS) for surgical procedures that are difficult, complex or complicated or situations where the service necessitated significantly more time to complete than the typical work effort.
How Much Does Medicare pay for modifier 22?
Reimbursement Information: If modifier 22 is approved, additional payment is 25% of the applicable allowable amount.
What is a 22 modifier?
modifier 22 is a representation by the provider that the treatment rendered on the date of. services was substantially greater than usually required. The use of modifier 22 does not. guarantee additional reimbursement. Thorough documentation indicating the substantial.
Can an assistant surgeon use modifier 22?
What does CPT modifier 22 mean?
modifier 22 is a representation by the provider that the treatment rendered on the date of. services was substantially greater than usually required. The use of modifier 22 does not. guarantee additional reimbursement.
What is a modifier 22?
Can you use modifier 22 and 52 together?
Modifier 22 should not be billed with Modifier 52-Reduced Services.
How to use modifier 22 in surgical documentation?
To use modifier 22 effectively, surgical documentation must include a description of: Why the care was especially difficult – the extenuating circumstances encountered intraoperatively that set this procedure apart from the standard expectation of complexity.
When to report modifier 22 to an E / M service?
Depending on the documentation, we may or may not allow additional reimbursement. Do not append modifier 22 to an E/M (Evaluation & Management) service; only report it with procedure codes that have a global period of 0, 10, or 90 days. Beginning July 5, 2016, we will reject claim submissions reporting modifier 22 without supporting documentation.
How to respond to an ADR for modifier 22?
We will send a development letter (ADR) asking for your additional information. When responding to the ADR, use the Modifier 22 Documentation Form and the appropriate Development Resolution form for your state: Documentation must include the operative report and a clear, concise statement indicating the substantial additional work.