# Serosal Tears in small bowel



## willishm2012

Procedure: 
Exploratory Laparotomy w/ extensive lysis of adhesions that took about an hour in order to be able to get to the pathology, also several small bowel serosal tear repairs, small bowel resection w/ primary anastomosis, reduction and repair of internal hernia, omentectomy. 

billed: 

44120/22
44050/51
44602/59 - this procedure is continuously denies this code, need some opinions here on this would you bill this code or not, I was told if tears are caused due to surgical procedure you do not bill for the repair. doctor doesn't say he caused these tears but deserosalization of intestine by definition is caused by surgery. 

any information would be helpful. 

Thank you,


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## EricaR

I never bill the perforation repairs, unless the actually have to resect and perfom an anastamosis b/c of the perforation.  Thats how I was taught.  Im sure when he was perfoming the lysis of adhesions these serosal tears were created, our Drs. never dictate that they created them either its just known that they weren't there prior to the surgery and then they were after the LOA.  I would not bill the 44602.


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## EricaR

Also NCCI manual addresses this issue in Chapter 6 section E.


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## willishm2012

:d thank you


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