# Laparotomy,Appy,drainage of intraabdominal abscess and lysis of abd adhesions



## Hopp (Apr 11, 2008)

Hi  Just wondering if someone could help me out.  I work for a general surgeon  he performed a laparotomy,appy open, drainage of intraabd.abscess and lysis of adhesions at the same time for a small bowel obst.secondary to inflammatory changes from a perf.gang.appendix with intra abd.abscess.   I explalined that I thought I could only code for the appy.  Is that right?  Thanks for your help


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## Erica1217 (Apr 12, 2008)

Yup, that's right, but if the lysis and/or drainage added a significant amount of time or difficulty to the procedure, you can bill it with a modifier -22.  

Per the NHIC Part B Resource (March 2005, pg 120) – “lysis of adhesions that requires greater than one hour would be considered outside the range for expected difficulty”

Modifier -22 article:  http://www.medicarenhic.com/providers/articles/mod22_0308.pdf

 Erica


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## cmartin (Apr 16, 2008)

Yes, 44960 would be only billable code
C.Martin CPC-GENSG


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