Don't know if this is what you're looking for, but I always tell the doctors that if they think the procedure was "unusual" - e.g. more extensive, more difficult - they MUST state so and why in their operative report so that the coder knows to use the -22 modifier and can easily highlight that portion of the note when submitting to insurance carriers.
So, for example, if the surgeon had to spend 55 minutes on lysis of adhesions before being able to get to the bowel for the planned procedure, the dictation should clearly state that additional time and effort required.
F Tessa Bartels, CPC, CEMC
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