breast reconstruction

My doctor has performed EXTENSIVE DIFFICULT 19370.50 capsulotomies and 11970 x 2 exchange tissue expanders with plascement implants. This is usually global, but he states this was not typical capsulotomies and wants to be paid for this...should I add the 22 modifier to 19370.5022 and send operative report for review or fight after the fact with a letter from the doctor stating such?