Pulmonology Coding Alert

Safe move: Check with payers on differing coverage policies.If you overuse modifier 22 (Increased procedural services) you may face increased scrutiny from your payers or even the Office of Inspector General (OIG). But if you avoid the modifier entirely, you're likely missing out on reimbursement your pulmonologist deserves.How it works: When a procedure requires significant additional time or effort that falls outside the normal effort of services described by a particular CPT code " and no other CPT code better describes the work involved in the procedure " you should look to modifier 22. Modifier 22 represents those extenuating circumstances that do not merit the use of an additional or alternative CPT code but instead when used can raise the reimbursement for a given procedure.Take a look at these three myths " and the realities " to ensure you don't fall victim to the modifier 22 catch-22.Myth 1: Morbid Obesity [...]