There is no reason to use a modifier 22 on an unlisted code because unlisted codes are given a value based on the work that is documented in the record for that particular encounter. Modifier 22 indicates that a given procedure required more physician work or time than that which is usually required for that procedure. Since unlisted codes have no description and no assigned value other than their associated medical record, modifier 22 does not add any information or serve any purpose since their is no 'usual' work associated with a procedure that has no assigned codes.Can modifier 22 be used on unlisted codes?
Pricing is not an easy thing to determine and you may want to involve your provider in this. I wouldn't use an open procedure as a baseline because the work involved in a open procedure is very different from a laparoscopic one - it's like comparing apples to oranges. I think it might work better to compare it to another laparoscopic procedure which involves a similar amount of work and time and adjust it accordingly. But if you're submitting it to an insurance payer, remember that they're the ones that the ones who will ultimately decide what to pay based on the notes you submit - you should set a price that's fair and recommend a similar code as a suggestion, but ultimately they are going to pay what they think it is worth, so unless they underpay it significantly, I wouldn't spend too much time on it.I didn't think we could. So I am using an unlisted laparoscopic code. I am trying to come up with a price. So I can compare it to an open code and increase the price by 20% because it is laparoscopic. If this procedure would be been open my physician would have liked to add the modifier 22 because he stated that in his operative report. Should I increase the price again then?