Neurosurgery Coding Alert

Follow this quick checklist of do's and don-ts before sending your modifier 22 (Increased procedural services) claim out the door: Do expect to produce a copy of the operative report upon payer request. Do prepare a separate page with your claim that explains, in clear language, why the service was especially difficult or time-consuming. Do compare the procedure to which you are appending modifier 22 to a typical procedure of the same type to better demonstrate to the payer the procedure's "increased"nature. Do use critical care codes instead of modifier 22 when appropriate. Do append modifier 22 to assistant-at-surgery procedures, if warranted. Don-t append modifier 22 to secondary procedures. Don-t use modifier 22 for re-operations or evaluation and management visits. Don-t assume lysis of average adhesions merits modifier 22. Don-t report modifier 22 simply because the physician performs a procedure via a lesser-preferred approach. Don-t substitute an unlisted-procedure code for modifier 22 to avoid carrier denials. Don't use modifier 22 recklessly. Save it for truly unusual or difficult circumstances when documentation can support the procedure's unusual nature.