Lyndapolk
New
Can you please help me understand this. (My office manager and doctor both agree on this, i do not think they are right on this.) We billed a LCC with Mod 22 since the procedure ended up being 4 hours long instead of 1 1/2 hours long it was converted to an open procedure. We billed with mod 22. I appealed and got an additional payment. So, the ins paid a total of 125% of allowable. My doctor wanted me to bill this by tripling the charge so he figures that 125% is not enough. My office manager seems to think that we should get 3x the allowed amount. I figure we should get probably 175% of the allowable. I am not sure how to explain this to them. Please help me or if you know of a link I can show them. Thanks.