Documentation for Modifier 22

Question:

What documentation is needed to report modifier 22?

Answer:

To be able to append modifier 22 which represents an increased procedural service, the provider needs to demonstrate that the work required was substantially greater than normally expected. To support this, the documentation must provide more than a blanket statement and include details as to why the work was greater. For example: “extensive lysis of adhesions took greater than 90 mins prior to reaching (the intended site)”.  The “what made it more work” is less crucial than the “details that explain why” it was more difficult so that payors will allow increased reimbursement. 

*This response is based on the best information available as of 7/11/24.