January 17, 2019

Question:
We can’t get a revision rhinoplasty paid.  Is it ok if we use the septoplasty code with modifier 22?

Answer:
No.  These procedures should be prior authorized in writing to ensure payment.  If you cannot obtain written approval from the payor prior to surgery, then we recommend you treat the patient as you would a cosmetic rhinoplasty and collect up front from the patient.  If the payor ultimately approves and reimburses you, then you can refund the patient.

*This response is based on the best information available as of 1/17/19.