{"id":4627,"date":"2019-06-25T02:19:55","date_gmt":"2019-06-25T02:19:55","guid":{"rendered":"https:\/\/medisysdata.com\/?p=4627"},"modified":"2023-10-15T09:20:33","modified_gmt":"2023-10-15T03:50:33","slug":"how-to-use-modifier-22-correctly-in-medical-billing","status":"publish","type":"post","link":"https:\/\/www.medisysdata.com\/blog\/how-to-use-modifier-22-correctly-in-medical-billing\/","title":{"rendered":"How to Use Modifier 22 Correctly In Medical Billing?"},"content":{"rendered":"\r\n<p>Using modifiers accurately is an important component in medical coding, billing, and reimbursement. Applying modifier 22 (Increased procedural services) can help increase reimbursement.<\/p>\r\n\r\n\r\n\r\n<p>Modifiers indicate that the work done by the provider does not exactly correspond to the CPT code descriptor. Appending incorrect modifiers or not appending the correct modifiers can attract audits, and lead to loss of revenue for the practitioner.<\/p>\r\n\r\n\r\n\r\n<h2 class=\"wp-block-heading\">WHAT IS MODIFIER 22?<\/h2>\r\n\r\n\r\n\r\n<p>As per the Centers for Medicare and Medicaid Services (<a href=\"https:\/\/www.cms.gov\/\" target=\"_blank\" rel=\"noopener\">CMS<\/a>), the correct use of modifier 22 applies mainly to surgeries for which work performed is significantly greater than usually required. Modifier 22 is appended to the CPT code of a primary or secondary procedure of a multiple procedure claims. Modifier 22 should be applied for only the most difficult procedures.<\/p>\r\n\r\n\r\n\r\n<h3 class=\"wp-block-heading\">INAPPROPRIATE USE OF MODIFIER 22:<\/h3>\r\n\r\n\r\n\r\n<p>Modifier 22 should not be used in the following cases:<\/p>\r\n\r\n\r\n\r\n<ul class=\"wp-block-list\">\r\n<li>If the bill is from a facility as modifier 22 is a physician-only code<\/li>\r\n<li>If another CPT code defines the provided service already<\/li>\r\n<li>If the additional work is included in the primary code itself and it&#8217;s not separately reimbursable<\/li>\r\n<li>If the additional work is only the surgeon\u2019s selection of procedure when a simpler approach would be enough<\/li>\r\n<li>No documentation is available<\/li>\r\n<\/ul>\r\n\r\n\r\n\r\n<h3 class=\"wp-block-heading\">DOCUMENTATION IS IMPORTANT<\/h3>\r\n\r\n\r\n\r\n<p>Documentation is essential when reporting a CPT code with modifier 22. The documentation must indicate the additional work performed and the reason for it. The payer can request additional documentation; hence the provider should be prepared to submit it. Many payers want a separate provider statement explaining how their service surpasses the standard procedure expectation and what was complicating factors involved.<\/p>\r\n\r\n\r\n\r\n<p>The documentation should be done immediately once the procedure is completed because it\u2019s easier to remember why the procedure was so difficult without passing time. You need to provide convincing evidence which states that the service or procedure was really extraordinary and significantly more difficult or time-consuming than usual, else your Payers won\u2019t accept a modifier 22 claim.<\/p>\r\n\r\n\r\n\r\n<p>Use comparative language and medical terms to clarify how the procedure was different than the typical procedure. You can use some electronic software to append a copy of an electronic note as an attachment to make supporting documentation available immediately.<\/p>\r\n\r\n\r\n\r\n<h3 class=\"wp-block-heading\">The documentation should have:<\/h3>\r\n\r\n\r\n\r\n<ul class=\"wp-block-list\">\r\n<li>A clear description of the procedure<\/li>\r\n<li>An account of additional diagnoses, pre-existing conditions<\/li>\r\n<li>Any unexpected findings or complicating factors that contributed to the extra time<\/li>\r\n<li>Pathology reports, progress notes, office notes, etc.<\/li>\r\n<\/ul>\r\n\r\n\r\n\r\n<h3 class=\"wp-block-heading\">HOW MEDICAL CODING OUTSOURCING CAN HELP YOU?<\/h3>\r\n\r\n\r\n\r\n<p>Medical coding outsourcing to a company with <a href=\"https:\/\/www.medisysdata.com\/medical-billing-companies\/request-a-call-back\">experienced certified coders<\/a> can ensure correctly coded claims and follow up for payments. However, detailed documentation is very important in meeting industry regulations.<\/p>\r\n<h3>Are You Ready to Get Billing?<\/h3>\r\n<p>Want to hire an <a href=\"https:\/\/www.medisysdata.com\/services\/\" target=\"_blank\" rel=\"noopener\">experts in Medical Billing and Coding<\/a> for your Practice? You are at the right place, what you need now is a partner who can finish out the rest of the work and make the technology and implementation just as simple. That\u2019s what the best medical billing company like Medisys Data Solutions Inc. can do. If you\u2019re ready to get started, <a href=\"https:\/\/www.medisysdata.com\/medical-billing-companies\/request-a-call-back\">schedule a meeting<\/a> with our Medical Billing Manager from filling out enquiry\u00a0form from our website!<\/p>\r\n","protected":false},"excerpt":{"rendered":"<p>Using modifiers accurately is an important component in medical coding, billing, and reimbursement. Applying modifier 22 (Increased procedural services) can help increase reimbursement. Modifiers indicate that the work done by the provider does not exactly correspond to the CPT code descriptor. Appending incorrect modifiers or not appending the correct modifiers can attract audits, and lead [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":5987,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_coblocks_attr":"","_coblocks_dimensions":"","_coblocks_responsive_height":"","_coblocks_accordion_ie_support":"","footnotes":""},"categories":[3],"tags":[30,87,6,14],"class_list":["post-4627","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-medical-billing-services","tag-leading-medical-billing-services-company","tag-medical-billing","tag-medical-billing-services","tag-top-medical-billing-company"],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v21.4 (Yoast SEO v27.2) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>How to Use Modifier 22 Correctly In Medical Billing?<\/title>\n<meta name=\"description\" content=\"Learn the proper way to utilize Modifier 22 in medical billing for accurate reimbursement and billing transparency.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.medisysdata.com\/blog\/how-to-use-modifier-22-correctly-in-medical-billing\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"How to Use Modifier 22 Correctly In Medical Billing?\" \/>\n<meta property=\"og:description\" content=\"Learn the proper way to utilize Modifier 22 in medical billing for accurate reimbursement and billing transparency.\" \/>\n<meta property=\"og:url\" content=\"https:\/\/www.medisysdata.com\/blog\/how-to-use-modifier-22-correctly-in-medical-billing\/\" \/>\n<meta property=\"og:site_name\" content=\"Leading Medical Billing Outsourcing Services Company in the USA\" \/>\n<meta property=\"article:published_time\" content=\"2019-06-25T02:19:55+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2023-10-15T03:50:33+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/www.medisysdata.com\/blog\/wp-content\/uploads\/2019\/06\/Blog_How-to-use-Modifier-22-correctly-in-Medical-Billing-1024x384-1.jpg\" \/>\n\t<meta property=\"og:image:width\" content=\"1024\" \/>\n\t<meta property=\"og:image:height\" content=\"384\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"author\" content=\"medisys\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"medisys\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"3 minutes\" \/>\n<!-- \/ Yoast SEO Premium plugin. -->","yoast_head_json":{"title":"How to Use Modifier 22 Correctly In Medical Billing?","description":"Learn the proper way to utilize Modifier 22 in medical billing for accurate reimbursement and billing transparency.","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/www.medisysdata.com\/blog\/how-to-use-modifier-22-correctly-in-medical-billing\/","og_locale":"en_US","og_type":"article","og_title":"How to Use Modifier 22 Correctly In Medical Billing?","og_description":"Learn the proper way to utilize Modifier 22 in medical billing for accurate reimbursement and billing transparency.","og_url":"https:\/\/www.medisysdata.com\/blog\/how-to-use-modifier-22-correctly-in-medical-billing\/","og_site_name":"Leading Medical Billing Outsourcing Services Company in the USA","article_published_time":"2019-06-25T02:19:55+00:00","article_modified_time":"2023-10-15T03:50:33+00:00","og_image":[{"width":1024,"height":384,"url":"https:\/\/www.medisysdata.com\/blog\/wp-content\/uploads\/2019\/06\/Blog_How-to-use-Modifier-22-correctly-in-Medical-Billing-1024x384-1.jpg","type":"image\/jpeg"}],"author":"medisys","twitter_card":"summary_large_image","twitter_misc":{"Written by":"medisys","Est. reading time":"3 minutes"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"Article","@id":"https:\/\/www.medisysdata.com\/blog\/how-to-use-modifier-22-correctly-in-medical-billing\/#article","isPartOf":{"@id":"https:\/\/www.medisysdata.com\/blog\/how-to-use-modifier-22-correctly-in-medical-billing\/"},"author":{"name":"medisys","@id":"https:\/\/www.medisysdata.com\/blog\/#\/schema\/person\/9f5cfa90ddf7805d6badbe7f652e4abf"},"headline":"How to Use Modifier 22 Correctly In Medical Billing?","datePublished":"2019-06-25T02:19:55+00:00","dateModified":"2023-10-15T03:50:33+00:00","mainEntityOfPage":{"@id":"https:\/\/www.medisysdata.com\/blog\/how-to-use-modifier-22-correctly-in-medical-billing\/"},"wordCount":527,"commentCount":0,"image":{"@id":"https:\/\/www.medisysdata.com\/blog\/how-to-use-modifier-22-correctly-in-medical-billing\/#primaryimage"},"thumbnailUrl":"https:\/\/www.medisysdata.com\/blog\/wp-content\/uploads\/2019\/06\/Blog_How-to-use-Modifier-22-correctly-in-Medical-Billing-1024x384-1.jpg","keywords":["leading medical billing services company","Medical Billing","medical billing services","top medical billing company"],"articleSection":["Medical Billing Services"],"inLanguage":"en","potentialAction":[{"@type":"CommentAction","name":"Comment","target":["https:\/\/www.medisysdata.com\/blog\/how-to-use-modifier-22-correctly-in-medical-billing\/#respond"]}]},{"@type":"WebPage","@id":"https:\/\/www.medisysdata.com\/blog\/how-to-use-modifier-22-correctly-in-medical-billing\/","url":"https:\/\/www.medisysdata.com\/blog\/how-to-use-modifier-22-correctly-in-medical-billing\/","name":"How to Use Modifier 22 Correctly In Medical Billing?","isPartOf":{"@id":"https:\/\/www.medisysdata.com\/blog\/#website"},"primaryImageOfPage":{"@id":"https:\/\/www.medisysdata.com\/blog\/how-to-use-modifier-22-correctly-in-medical-billing\/#primaryimage"},"image":{"@id":"https:\/\/www.medisysdata.com\/blog\/how-to-use-modifier-22-correctly-in-medical-billing\/#primaryimage"},"thumbnailUrl":"https:\/\/www.medisysdata.com\/blog\/wp-content\/uploads\/2019\/06\/Blog_How-to-use-Modifier-22-correctly-in-Medical-Billing-1024x384-1.jpg","datePublished":"2019-06-25T02:19:55+00:00","dateModified":"2023-10-15T03:50:33+00:00","author":{"@id":"https:\/\/www.medisysdata.com\/blog\/#\/schema\/person\/9f5cfa90ddf7805d6badbe7f652e4abf"},"description":"Learn the proper way to utilize Modifier 22 in medical billing for accurate reimbursement and billing transparency.","breadcrumb":{"@id":"https:\/\/www.medisysdata.com\/blog\/how-to-use-modifier-22-correctly-in-medical-billing\/#breadcrumb"},"inLanguage":"en","potentialAction":[{"@type":"ReadAction","target":["https:\/\/www.medisysdata.com\/blog\/how-to-use-modifier-22-correctly-in-medical-billing\/"]}]},{"@type":"ImageObject","inLanguage":"en","@id":"https:\/\/www.medisysdata.com\/blog\/how-to-use-modifier-22-correctly-in-medical-billing\/#primaryimage","url":"https:\/\/www.medisysdata.com\/blog\/wp-content\/uploads\/2019\/06\/Blog_How-to-use-Modifier-22-correctly-in-Medical-Billing-1024x384-1.jpg","contentUrl":"https:\/\/www.medisysdata.com\/blog\/wp-content\/uploads\/2019\/06\/Blog_How-to-use-Modifier-22-correctly-in-Medical-Billing-1024x384-1.jpg","width":1024,"height":384,"caption":"How to Use Modifier 22 Correctly In Medical Billing?"},{"@type":"BreadcrumbList","@id":"https:\/\/www.medisysdata.com\/blog\/how-to-use-modifier-22-correctly-in-medical-billing\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https:\/\/www.medisysdata.com\/blog\/"},{"@type":"ListItem","position":2,"name":"How to Use Modifier 22 Correctly In Medical Billing?"}]},{"@type":"WebSite","@id":"https:\/\/www.medisysdata.com\/blog\/#website","url":"https:\/\/www.medisysdata.com\/blog\/","name":"Leading Medical Billing Outsourcing Services Company in the USA","description":"You Cure We Secure","potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/www.medisysdata.com\/blog\/?s={search_term_string}"},"query-input":{"@type":"PropertyValueSpecification","valueRequired":true,"valueName":"search_term_string"}}],"inLanguage":"en"},{"@type":"Person","@id":"https:\/\/www.medisysdata.com\/blog\/#\/schema\/person\/9f5cfa90ddf7805d6badbe7f652e4abf","name":"medisys","image":{"@type":"ImageObject","inLanguage":"en","@id":"https:\/\/secure.gravatar.com\/avatar\/79d7a562f3c08c721df502178306075752b41ea9a19670eb43265d6e0f4a501d?s=96&d=mm&r=g","url":"https:\/\/secure.gravatar.com\/avatar\/79d7a562f3c08c721df502178306075752b41ea9a19670eb43265d6e0f4a501d?s=96&d=mm&r=g","contentUrl":"https:\/\/secure.gravatar.com\/avatar\/79d7a562f3c08c721df502178306075752b41ea9a19670eb43265d6e0f4a501d?s=96&d=mm&r=g","caption":"medisys"},"sameAs":["https:\/\/www.medisysdata.com\/blogs"],"url":"https:\/\/www.medisysdata.com\/blog\/author\/admin\/"}]}},"_links":{"self":[{"href":"https:\/\/www.medisysdata.com\/blog\/wp-json\/wp\/v2\/posts\/4627","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.medisysdata.com\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.medisysdata.com\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.medisysdata.com\/blog\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.medisysdata.com\/blog\/wp-json\/wp\/v2\/comments?post=4627"}],"version-history":[{"count":1,"href":"https:\/\/www.medisysdata.com\/blog\/wp-json\/wp\/v2\/posts\/4627\/revisions"}],"predecessor-version":[{"id":9541,"href":"https:\/\/www.medisysdata.com\/blog\/wp-json\/wp\/v2\/posts\/4627\/revisions\/9541"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.medisysdata.com\/blog\/wp-json\/wp\/v2\/media\/5987"}],"wp:attachment":[{"href":"https:\/\/www.medisysdata.com\/blog\/wp-json\/wp\/v2\/media?parent=4627"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.medisysdata.com\/blog\/wp-json\/wp\/v2\/categories?post=4627"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.medisysdata.com\/blog\/wp-json\/wp\/v2\/tags?post=4627"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}