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MEDICAID REIMBURSEMENT POLICYModifier 22 Active ___ Policy Number: Surgery/Interventional Procedure 004 Policy Title: Modifier 22 Section: Surgery/Interventional Procedure Effective Date: 01/01/24
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How to fill out modifier 22 increased procedural

01
Ensure the medical record clearly supports the use of modifier 22 for increased procedural services.
02
Submit a separate report detailing the reasons for the increased complexity of the procedure.
03
Include information on the additional time, effort, and skill required to perform the procedure.
04
Be prepared to provide documentation upon request to justify the use of modifier 22.

Who needs modifier 22 increased procedural?

01
Healthcare providers who have performed a procedure that required significantly more time, effort, and complexity than usual may need modifier 22 increased procedural.
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Modifier 22 is used when the work required to perform a procedure is substantially greater than typically required.
The surgeon or provider performing the procedure is responsible for determining if modifier 22 is necessary and submitting it with the claim.
Modifier 22 should be added to the claim form with a description of the additional work performed and any relevant documentation to support the need for the modifier.
The purpose of modifier 22 is to indicate that a procedure required significantly more time, effort, and resources than usual.
The additional work performed, the reason why it was necessary, and any supporting documentation should be included when using modifier 22.
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