Modifier 22 - Increased Procedural Services

• Modifier 22 not intended for use with E/M service

• Modifier 22 should not be used with a procedure if extra effort performed has a specific procedure code.

• Modifier 22 is intended to use for physicians, not for institutional reporting.

Use modifier for below reasons.

1. Increased intensity

2. Increased time

3. Technical difficulty

4. Severity of the patient’s condition

5. Physical and mental effort

Above should have proper explanation in the report, not just statements like "This was a difficult procedure", "patient is very obese", "Surgery took additional hours" etc. Look for how and why procedure has a increased difficulty level and if you are not finding convincing information then query physician.