# Lysis of Adhesions with Lap Chole



## KristineR (Nov 18, 2009)

Help!

I am new to general surgery coding.  When our surgeons do extensive lysis of adhesions prior to a laparoscopic procedure such as cholecystectomy, we find that the lysis of adhesions gets denied as bundled/inclusive almost all of the time.  Our surgeons document the time spent (which can be quite lengthy) on the op note.  Is anyone seeing reimbursement on both procedures, and if so, how are you billing it (modifiers, etc) and which payers are reimbursing?

Thank you in advance to anyone who replies!  If everyone gets denials of this nature, it will at least help me to know if I have a fighting chance or not. 

Kristine Robicheaux CPC


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## lindacoder (Nov 18, 2009)

I usually increase the amount for the lap chole and put a 22 modifier on it. If it's commercial insurance I write a short note to go with the op stating that I am requesting greater reimbursement for the lysis of adhesions and send the op note along with it. It usually generates around $200 more for the claim. If it's Medicare I put a 22 on it, wait for payment and then send in a redetermination and they usually pay.


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