# lysis of adhesions-Reviewing a lap hernia



## Christine38 (Oct 1, 2008)

Reviewing a lap hernia repair that took place with a lysis of adhesions.  I see that according to the NCCI - during a lap procedure the lysis would not be reported separtely, but do we know of anything to support it being reported separtely if it takes 3 hours.  The hernia repair takes on average 3-4hours....wouldnt the time of an additional 3 hours provoke separate billing?
Thank you.


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## Anastasia (Oct 1, 2008)

You could use a 22 modifier and submit the claim with a very detailed operative report that explains the necessity of this billing. A letter from the surgeon should  be sent also.  Depending on the carrier, you may get this paid.


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## Treetoad (Oct 1, 2008)

I agree with Anastasia.  Included in the note should be an explanation of how much additional time was spent on the lysis of adhesions and why.


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## ARCPC9491 (Oct 1, 2008)

We also use the 22 mod for lysis of adhesions. We have no luck getting it paid though - yes sometimes it takes 3 hours and lots of time .... i don't know why they won't pay - they are so hell bent on the bundling factor and don't care about the extra time/complexity

we've sent records, letters, appeals... nothing...


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