COMPLEX or difficult TKA?

reewriter

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Lewiston, ME
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Is there a way to code an "exceptionally difficult" total knee arthroplasty? I thought perhaps adding the -22 modifier but would this do anything for the physician's reimbursement? Any information would be much appreciated.
 

kevbshields

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Louisville, KY
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Yes, a 22 Modifier would be appropriate and depending upon the payer, may increase reimbursement. In some cases, there is nothing you can do to receive reimbursement for extra work--regardless.

However, append your Mod-22, send your op report and hope for the best.

Good luck.
 

FREEPONY

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Sacramento
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I have used the modifier -22 with success. My physician dictates a separate note as to why he is using the -22 modifier. He indicates the difficulty of the case and how much extra time he spent. Medicare even paid additional reimbursement for this.

Debbie Kline, CMA
 
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