Oncology & Hematology Coding Alert

Make sure you run through your list of do's and don'ts before submitting your claim for payment and/or into the review process:   Do include a copy of the operative report with your claim.
  Do check your carrier's local medical review policy before submitting a claim for modifier -22 - not all private payers honor this modifier.
  Do use critical care codes instead of modifier -22 when appropriate.
  Do be sure at least 25 percent more time/effort than usual was required to perform the procedure.
  Do submit your claim on paper - claims for modifier -22 cannot be submitted electronically.
  Do append modifier -22 to assistant-at-surgery procedures.   Don't append modifier -22 to secondary procedure codes.
  Don't append modifier -22 to E/M codes. Modifier   -22 is only for use with procedural services.
  Don't use modifier -22 for re-operations.
  Don't assume the lysis of an average number of adhesions merits the use of modifier -22.
  Don't report modifier -22 simply because the physician performs a procedure using a lesser-preferred approach.
  Don't substitute an unlisted-procedure code instead for modifier -22 to avoid carrier denials.