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Modifiers: Follow 5 Steps for Modifier 22 Claim Success

Published in Gastroenterology Coding Alert, July 2010

Your documentation determines the ‘unusuality’ of the situation.
Payoff: The Medicare rate for dysphagia treatment is about $102 (based on RVU of 2.77 and a conversion factor of $36.8729). The treatment plan for dysphagia can include further diagnostic testing, diet/liquid modifications, oral motor exercises, deep pharyngeal neuromuscular stimulation (DPNS), or neuromuscular electrical stimulation (NMES).
3. Support Treatment Code with DPNS Therapy
Since treatment for pharyngeal dysphagia (787.23) could  involve DPNS therapy (direct neuromuscular stimulation to the pharyngeal musculature), [...]


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Published in Gastroenterology Coding Alert, July 2010
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