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time spent & mod 22

  1. Default time spent & mod 22
    Medical Coding Books
    If a provider does an exam and has some counseling and at the end he puts that he spent greater than 40 minutes w/pt., then wants and E&M level of 99205. I am questioning the the time spent. Should a query him to a specific time? Now on mod 22, one surgeon, assist surgeon, and they did 2 seperate procedures (oh..on the same day) and the main surgeon wants a mod 22 on both procedures, can that be done. It is my understanding that a mod 22 can only be put on the main procedure.

    Thanks for anyones help on this.

  2. #2
    Default
    Quote Originally Posted by samyjw View Post
    If a provider does an exam and has some counseling and at the end he puts that he spent greater than 40 minutes w/pt., then wants and E&M level of 99205. I am questioning the the time spent. Should a query him to a specific time? Now on mod 22, one surgeon, assist surgeon, and they did 2 seperate procedures (oh..on the same day) and the main surgeon wants a mod 22 on both procedures, can that be done. It is my understanding that a mod 22 can only be put on the main procedure.

    Thanks for anyones help on this.
    For time spent, all e/m's include counseling, if he is intending to base his office visit on time there are specific requirements for documentation on time based e/m's, which I believe are in your cpt as well as medicare/cms website has additional resource material. He could look at prolonged service codes 99354-99357, those also have specific documentation requirements.

    I have never heard you can only put mod 22 on only one procedure,but that may be (anyone else?). I would put 22 onto any/all procedures he felt went above and beyond usual time/difficulty/ect....I always send a cover letter when I bill 22 mod, with my doc explaining who/what/why procedure was more difficult, I have "heard" that if you dont include cover letter they just ignore your 22. I would not put a 22 on an assistant surgeon.

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