Wiki Modifier 22 - Would like some input on how to get

[efuhrmann]

Would like some input on how to get claims paid the first time when appending modifier 22? How do you get the reports to go with the claim for electronic submission?

 

[Lisa Bledsoe]

Hi Liz - The only system I know of is for Medicare (they have the faxed info page for that). As for other payers, we wait to see what they allow and if it appears they are not allowing for the -22, we appeal. I don't think there's any other way to do it.
Lisa

 

[fuga]

Modifier 22

For all our payers except (Medicare) we have to appeal the 22 w/documenation after initial payment. We run a monthly report for all claims w/modifier 22 and then appeal for the additional consideration. Good luck!

 

[RebeccaWoodward*]

We add an electronic note to block 19 on the claim form. We provide a brief description of what was more complex about the procedure. The majority of the time our carries would request the medical record in writing. Only a couple of times did the explanation in block 19 suffice.