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COMPLEX or difficult TKA?

  1. #1
    Question COMPLEX or difficult TKA?
    Medical Coding Books
    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.

  2. #2
    Louisville, KY
    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.

  3. #3
    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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