Modifier 22: Increased Procedural Services - Documenting and Defending the Claim

60 Minutes
AAPC approved for 1 CEU
CEU expires 9/30/2027

Participants will explore the CPT fundamentals for modifier 22, the exceptional cases that justify its use, and the critical coding situations where it’s a strict no-go — including E/M and anesthesia services, add-on codes, facility claims, and procedures outside a 0-, 10-, or 90-day global period. Special focus is given to leveraging the CMS Physician Work Time file, as payers do, along with best practices for documentation, cover letter content, and justifying the increased percentage.

The course wraps up with 10 real-world operative note case studies from orthopedics, general surgery, vascular surgery, and neurosurgery. Each case is analyzed to determine if the modifier is supported, with clear explanations of the coding reasoning. Participants will leave equipped to identify true added complexity from routine variation, craft compelling appeal packages that withstand scrutiny, and advise surgeons on when administrative effort is justified for maximum impact.

Learning Objectives
Upon completion of this course, participants will be able to:
• Classify the CPT definition of modifier 22 to distinguish substantially increased procedural work from routine case-to-case variation.
• Analyze operative note documentation against the CMS Physician Work Time file to determine whether reported operative time supports a modifier 22 request.
• Evaluate whether a more specific CPT code describes the work performed before appending modifier 22.
• Formulate an appeal strategy for denied modifier 22 claims, weighing expected reimbursement against administrative cost and payment delay.

Reminder: You have 30 days to complete the course from the day you register. 

AAPC Accreditation

This program meets AAPC guidelines for 1.0 CEUs. Can be split between Core A and all specialties except CIRCC for continuing education units.

Accreditation expiration date: 9/30/2027

Important Note: Please be sure to complete the course before the CEU expiration date if you plan to obtain CEU credits.

Course Access and Expiration

You have 30 days to complete a course from the day you register. After 30 days your access will expire. 

Should you have questions, please contact us at [email protected]

All cancellations and transfer requests will adhere to the KZA Cancellation and Refund Policy.

Please email at [email protected] to submit your transfer or cancellation request after reviewing the policy above.

Need to register multiple attendees? Click HERE for information. If you have any questions or need additional assistance, email [email protected] or call 312-642-8310.

Thank you!

KZA