What does modifier 22 signify when appended to a procedural code?

Modifier 22 is used to indicate that the service provided was significantly more complex or required substantially more work than typically required for the procedure performed. This modifier acknowledges that the situation was extraordinary, and that the complexity involved warrants additional reimbursement beyond what is usually billed for that procedure.

When modifier 22 is appended to a procedural code, it signals to the payer that the provider is requesting additional consideration for the increased effort and resources utilized during the procedure. This can include factors like an extended duration of the procedure, a higher level of risk, or specialized techniques that contributed to the elevated level of service delivered. It is essential for the documentation to support this modifier to justify the increased payment.

Understanding this modifier is crucial in ensuring that the procedural codes accurately reflect the complexity of the services rendered, promoting fair compensation for the providers' efforts.