BMI: New code choices could support higher coding, but don't assume you need -22

This year's right-in fifth-digit diagnosis codes in quest of BMI help you document a long-suffering's condition better, especially when the persevering's BMI might lead to greater degree complex risk factors for the anesthesiologist to feel of. However, having documentation of a great BMI does not automatically lead to more payments. Watch two areas prior to proud you can automatically add modifier 22 (Increased procedural services) owing to BMI and potentially score a 20-30 percent higher pay for the procedure.

Not all morbid corpulence means modifier 22

A patient is taken to have ~ing morbidly obese when his or her BMI is 40 or again. Just-in BMI codes for this year contain:

V85.41 -- BMI 40.0-44.9, grown-up person V85.42 BMI 45.0-49.9, person of mature age V85.43 -- BMI 50.0-59.9, adult V85.44 -- BMI 60.0-69.9, grown up V85.45 -- BMI 70 and excessively, adult While morbid obesity can subsist a proper reason to report modifier 22, do not assume that you should for ever add the modifier just because the patient is morbidly obese. Extra time does not ever mean more money Modifier 22 is hind part before extra procedural work and even nevertheless morbid obesity might lead to extra work, it's not enough in itself. Unless time is betokening or the intensity of the operation is increased owing to obesity, therefore modifier 22 shouldn't be added. Here's the seize: CPT doesn't provide specific control on how much time and/or percentage of increased time or work the provider must document to have a right to modifier 22. However, the rule of the thumb is your provider grape-juice spend at least 50 percent again time and/or put in at least 50 percent more effort than normal for you to add modifier 22. There should be documentation of at least a 50 percent increase in work and/or time to exculpate tge use of modifier 22. Document: One stable-shot way to demonstrate a management's increased nature is to liken the actual time, effort or state of affairs to your anesthesiologist's typical time and attempt for that particular procedure. A remark like "The procedure required 90 minutes to consummate, instead of the usual 35-45 minutes" have power to be useful. Remind your anesthesia providers to clearly writing the reason for the increased time and essay in the patient's record. As these claims normally beseech manual review or an appeal in manage to get additional payment, be strong the operative note is detailed and especial to support the medical necessity and reasons because of the use of modifier 22. An superadded letter from the doctor to propitious the case and the reasons for requesting more payment that is written in layman's terms will help to appeal the claim. For to a greater degree on this and for other specialty-specified articles to assist your anesthesia coding, sign up during a good medical coding resource like Coding Institute.