Modifier -22 Unusual Procedural Services

Modifier 22 is used when services provided are greater than usually required for the listed procedure and not covered under any other procedure code.

This modifier can used in the following sections of the CPT® code set:

• Anesthesia
• Surgery
• Radiology
• Laboratory and Pathology
• Medicine

Modifier -22 should only be used when there is a significant increase in physician work, time and complexity of the procedure normally performed. Some examples that would qualify for -22 are:

• Trauma that significantly complicates the particular procedure and cannot be reported with any other procedure
• Signficiant scarring that requires extra time and work
• Morbid obesity making extra work for the physician
• Increased time resulting from the extra work by the physician

Since most payers require documentation to accompany modifier -22, the procedure or operative note should be sent along with a concise statement that explains how the service differs fromt the usual.