I have used modifier 22 in the past with success. You need to specify the extensiveness of the operation not so much the extra hour. Ask yourself and the Dr. "why did it take longer?" and "What made it more extensive?". Modifier 22 is no doubt harder to get paid extra on, but if you prove to the insurance company that there is substantially a greater service provided; and additional work was completed they should'nt deny that! If you still do not have luck after this, I would appeal it as far as you can go, if you feel that it truly was a substantial extensive amount of work. I have had to go up the levels of appeal in the past to get it paid with success.
Good luck and keep on trying it will be worth it in the end!
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