What is modifier 22?

Modifier 22 is a reimbursement modifier used in medical billing to indicate that a procedure or service required significantly more time, effort, and resources than what is typically required. This modifier is used to request additional payment for these extra costs and is typically attached to the procedure code on the claim form.

For a modifier 22 to be appropriate, the additional time and effort required for the procedure must be well documented in the patient's medical record. This documentation should include specific details about why the procedure was more complex or took longer than usual, as well as any unexpected complications that may have arisen during the procedure.

It is important to note that not all payers will reimburse for modifier 22, as it is considered a discretionary modifier. It is recommended to check with individual payers to determine their specific policies on reimbursement for modifier 22.

Overall, modifier 22 should only be used when there is clear documentation to support the additional resources required for a procedure, and it should be used judiciously to ensure appropriate reimbursement.