# Laparoscopic cholecystectomy



## amdmedicalbill (May 23, 2011)

Hello Everyone !
I'm new to the forum and also new to General Surgery billing and was wondering if anyone could help me with a coding question ?  The surgeon is billing 47562 for Laparascopic Cholecystectmy and he also wrote "Lysis of Bowel Adhesions-modifier 22".  I can't find a code that i would use to code the Lysis of Bowel Adhesions and then append the modifier 22 to it.  Can someone help me with that code ? Also, since he's appending modifier 22, i'm assuming the insurance company would want the claim sent on a CMS-1500 with the operative notes attached ?  Thank you for any guidance you can give !


----------



## mjewett (May 23, 2011)

Lysis of adhesions when performed alone is:  44005 (open) or 44180 (laparoscopic).  Lysis of adhesions is never separately billable, when performed at the same time as any other major surgery. (For example: cholecystectomy) 

Sometimes if the lysis of adhesion was very difficult, and time consuming, and If your surgeon documented the unusual circumstance involved.  Then you can add modifier 22 to the major surgery code for example:  47562-22

Hope this is helpful


----------



## jdibble (May 23, 2011)

amdmedicalbill said:


> Hello Everyone !
> I'm new to the forum and also new to General Surgery billing and was wondering if anyone could help me with a coding question ?  The surgeon is billing 47562 for Laparascopic Cholecystectmy and he also wrote "Lysis of Bowel Adhesions-modifier 22".  I can't find a code that i would use to code the Lysis of Bowel Adhesions and then append the modifier 22 to it.  Can someone help me with that code ? Also, since he's appending modifier 22, i'm assuming the insurance company would want the claim sent on a CMS-1500 with the operative notes attached ?  Thank you for any guidance you can give !



Lysis of adhesions is usually bundled with the procedure so you would not bill a separate code for the lysis.  I think what he wants you to do is use the modifier on the 47562 for the extra work of the lysis of the adhesions.  Yes you would need to send the OP notes with the claim.  The doctors OP note must also substantiate the reason for the additional work, and the time and effort otherwise he will not get the additional reimbursement.

Hope this helps.


----------



## amdmedicalbill (May 23, 2011)

I wanted to thank you for the replies !  This gave me a good understanding of how to bill a claim when lysis of adhesions was performed during a major procedure.  I appreciate the answers !


----------

