# Laparoscopic lysis of adhesions



## graciejean (Apr 22, 2010)

The procedure was laparoscopic lysis of adhesions. When the second trocar site placed in suprapubic area , the prbe was used to push most of the bowels back into the upper abdomen. There were significant adhesions to the back of the uterus. The bowel was adhesed to the posterior uterus and the cul-de-sac. Since the Dr was unable to see into the cul-de-sac or left adenexa a general surgeon was called in to assist on adhesions of the bowel of the back of the uterus. Some adhesions were safely taken down. The right ovary and tube were fully visualized and normal with no evidence of torsion and actually the tube appeared halthy with normal fimbrae. However the left side, there were more adhesions in this area. I was able to glimpse the left tube. There was possibly some edema, but definitely without any adhesion and part of the ovary appeared to be normal. Again, I was really unable to clearly see into the cul-de-sac because of the dense adhesions and we were abel to completely remove the bowel off the uterus for this reason as well. At this point, the procedure was aborted feeling itunsafe to contimue with adheiolysis without this patient having a bowel prep. Hwoever, the GYN organs were visualized and appeare normal as well as the appendix. 

How would this be coded? It seems more work involved than just 58660.


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## LTibbetts (Apr 23, 2010)

In some cases, you can add the -22, but you *must* make sure that the documentation supports it and you have to submit the op note with the claim as well. The other thing is that the surgery was aborted, which in some cases requires the -52 modifier for reduced services. You should query your doc if you aren't sure.


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