I have read that if it takes more than the usual 20 minutes for more polyps or maybe a tortuous colon then you would append the 22 modifier using an example of 90 or 120 minutes. And remember it must have the proper documentation to prove this.
"A colonoscopy is performed on a patient with a tortuous colon. Instead of taking the usual 20 minutes to complete, the gastroenterologist spends 90 minutes navigating the scope through the twists and turns of the patients lower intestine. Modifier -22 (unusual procedural services) is attached to the colonoscopy procedure code when the claim is filed."
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