During a colonoscopy the gastroenterologist removes 20 polyps from various regions of the colon using hot biopsy forceps technique, and spends 2 hours for the procedure.
Code 45384-22: Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps.
Even when the CPT code describes polyps (plural), the physician work exceeded the usual procedure, so append modifier 22.
The surgeon performs a laparoscopic cholecystectomy with exploration of the common bile duct. During the procedure, the surgeon encountered multiple adhesions. The surgeon spends two hours to remove the adhesions.
Code 47564-22: Laparoscopy, surgical; cholecystectomy with exploration of common duct.
Modifier 22 is reported as additional surgeon effort is required to complete the surgery