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Wiki 22 Modifier - I have a question about the 22 modifier

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jlb0807

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Hello!

I have a question about the 22 modifier. I'm pretty sure I know the answer, but our doctor likes things to be in writing and I can't find anything.

The doctor did an appendectomy with an ovarian cyst drainage. The codes were 44970 and 58805. According to CCI edits, we can't bill those together. I tasked my doctor to let him know that we couldn't bill them together and he wants me to bill the 44970 with a 22 modifier. I don't believe I can since it was only 15 extra minutes for the ovarian cyst.

Any thoughts?

Thanks in advance!
 
jlb0807 said:
Hello!

I have a question about the 22 modifier. I'm pretty sure I know the answer, but our doctor likes things to be in writing and I can't find anything.

The doctor did an appendectomy with an ovarian cyst drainage. The codes were 44970 and 58805. According to CCI edits, we can't bill those together. I tasked my doctor to let him know that we couldn't bill them together and he wants me to bill the 44970 with a 22 modifier. I don't believe I can since it was only 15 extra minutes for the ovarian cyst.

Any thoughts?

Thanks in advance!
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I look for 3 points - altered surgical field, morbid obesity with a high BMI that affects the surgical area and a more difficult, extensive procedure. I think what your doc is doing is trying to get a few extra $$ because of CCI edits. Little tricky but also remember about 20% or so of the 22 mod claims get paid so I would think twice.
 
Incidental appendectomy?
Im looking at +44955 and the note above it says if necessary to report, add modifier -52? Check out top of page 255 in the 2013 CPT book
 
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