What is Medicare modifier 22 explanation form?

Modifier 22 is defined as "Increased Procedural Services: When the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code.

What is an example of a modifier 22?

The American Urological Association (AUA) provides the following example of a situation where the use of modifier 22 may be justified: Patient is scheduled for a radical nephrectomy with regional lymphadenectomy. The patient is very overweight.

What is the description of 22 modifier?

Modifier -22: Increased Procedural Services. This modifier is used to identify a service that requires significantly greater effort, such as increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required, than is usually needed for that procedure.

What is an example of a modifier 22?

The American Urological Association (AUA) provides the following example of a situation where the use of modifier 22 may be justified: Patient is scheduled for a radical nephrectomy with regional lymphadenectomy. The patient is very overweight.

How do I document a modifier 22?

To use modifier 22 effectively, surgical documentation must include a description of: Why the care was especially difficult the extenuating circumstances encountered intraoperatively that set this procedure apart from the standard expectation of complexity.

Which scenario qualifies for modifier 22?

Additional scenarios where modifier 22 could apply include maternity care involving cesarean delivery of multiple gestations, encountering exceptionally large tumors during a procedure or an event of excessive blood loss during surgery.

What is Medicare 22 modifier?

Modifier 22 is defined as "Increased Procedural Services: When the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code.

How much does modifier 22 increase reimbursement?

BCBSND will reimburse procedure codes billed with the modifier 22 appended with a 20% increase to the physician fee schedule rate. Note: This is not applicable to services billed on the UB-04 Claim Form.

Get Modifier 22 Explanation Form

Q: What is Medicare modifier 22 explanation form?

Modifier 22 is defined as &quot;Increased Procedural Services: When the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code.

Q: What is Medicare 22 modifier?

Modifier 22 is defined as &quot;Increased Procedural Services: When the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code.

Modifier -22 Unusual Procedural Services Explanation Form For submission with claim and operative report When submitting a claim with a modifier 22 you are indicating that the procedure is greater than that usually required for the listed procedure. The Centers for Medicare and Medicaid Services CMS has suggested that this modifier should be primarily used where a procedure or service required an unusual amount of time or effort. By including this form with your operative report you will be providing our clinical reviewers your individual input into the unusual nature of the procedure or service provided* Please copy this form and submit as needed* Provider Identification Number Patient ID Number Patient Name Date of Surgery Length of Surgery Unusual circumstances during the surgery that may warrant additional reimbursement Name please print Title Signature Date R06005. In Connecticut Anthem Blue Cross and Blue Shield is a trade name of Anthem Health Plans Inc* In New Hampshire Anthem Blue Cross and Blue Shield is a trade name of Anthem Health Plans of New Hampshire Inc* In Maine Anthem Blue Cross and Blue Shield is a trade name of Anthem Health Plans of Maine Inc* Independent licensees of the Blue Cross and Blue Shield Association Registered marks of the Blue Cross and Blue Shield Association. The Centers for Medicare and Medicaid Services CMS has suggested that this modifier should be primarily used where a procedure or service required an unusual amount of time or effort. By including this form with your operative report you will be providing our clinical reviewers your individual input into the unusual nature of the procedure or service provided* Please copy this form and submit as needed* Provider Identification Number Patient ID Number Patient Name Date of Surgery Length of Surgery Unusual circumstances during the surgery that may warrant additional reimbursement Name please print Title Signature Date R06005. By including this form with your operative report you will be providing our clinical reviewers your individual input into the unusual nature of the procedure or service provided* Please copy this form and submit as needed* Provider Identification Number Patient ID Number Patient Name Date of Surgery Length of Surgery Unusual circumstances during the surgery that may warrant additional reimbursement Name please print Title Signature Date R06005. In Connecticut Anthem Blue Cross and Blue Shield is a trade name of Anthem Health Plans Inc* In New Hampshire Anthem Blue Cross and Blue Shield is a trade name of Anthem Health Plans of New Hampshire Inc* In Maine Anthem Blue Cross and Blue Shield is a trade name of Anthem Health Plans of Maine Inc* Independent licensees of the Blue Cross and Blue Shield Association Registered marks of the Blue Cross and Blue Shield Association. The Centers for Medicare and Medicaid Services CMS has suggested that this modifier should be primarily used where a procedure or service required an unusual amount of time or effort. By including this form with your operative report you will be providing our clinical reviewers your individual input into the unusual nature of the procedure or service provided* Please copy this form and submit as needed* Provider Identification Number Patient ID Number Patient Name Date of Surgery Length of Surgery Unusual circumstances during the surgery that may warrant additional reimbursement Name please print Title Signature Date R06005. In Connecticut Anthem Blue Cross and Blue Shield is a trade name of Anthem Health Plans Inc* In New Hampshire Anthem Blue Cross and Blue Shield is a trade name of Anthem Health Plans of New Hampshire Inc* In Maine Anthem Blue Cross and Blue Shield is a trade name of Anthem Health Plans of Maine Inc* Independent licensees of the Blue Cross and Blue Shield Association Registered marks of the Blue Cross and Blue Shield Association.

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