Unlisted Procedures and the Use of Modifier 22

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The CPT manual has over 10,000 codes, but there isn’t always a CPT code that represents a unique or new procedure, or a procedure that was more complex than normal due to special circumstances. Unlisted procedure codes and modifier 22 can help with these special cases to share with the insurance company those times when special, distinctive situations occur. This webinar will examine the use but will also look at options available when insurance companies are not reimbursing these cases.

Must Attend For

✓ Physicians
✓ Scribes
✓ Prior Authorization
✓ Qualified Healthcare Professionals
✓ Biller
✓ Claims Adjuster
✓ Nurses
✓ Coder
✓ Medical Assistants
✓ Surgery Scheduler

• Proper documentation for

• Unlisted codes and their purpose

• Determining what to charge for these cases

• Circumstances that require a modifier 22

• Verification that reimbursement received is appropriate.

• Writing appeals to the insurance company when there is a denial or unacceptable reimbursement

• Correct uses of unlisted codes and modifier22

• Discussion of documentation necessary for proof of situations eligible for the coding.

• Writing appeals for insurance company denials for these cases

• Unlisted codes and modifier 22 situations like to be avoided because not only does the documentation have to clearly support the coding and billing, but the insurance companies most commonly deny these cases delaying reimbursement and causing physician’s staff to spend countless hours appealing these cases to receive the deserved reimbursement.

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Presenter

Lynn M. Anderanin

(CPC, CPMA, CPC-I, CPPM, COSC)