# Laparoscopic lysis of omental adhesions



## sknapp56

Which code would be used for a laparoscopic lysis of omental adhesions the 58660-which lists the 568.0 as a payable dx code or 49329 unlisted laparoscopic proceedure? Would like other coders opinions. Thank you in advance


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## preserene

Could you post the op. procedure Or can you give the details of where was it attached- to ovary ,tubes, to uterus , intestine or just to the abdominal wall?


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## sknapp56

The omental adhesions were from the omentum to the anterior abdominal wall.


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## preserene

I would go for enterolysis.

[Laparoscopic Peritoneal Cavity Adhesiolysis:
Adhesiolysis by laparoscopy and laparotomy can be very time-consuming and technically difficult and is best performed by an expert surgeon. However, despite lengthy laparoscopic procedures (two to four hours), most patients are discharged on the day of the procedure, avoid large abdominal incisions.
*Peritoneal adhesiolysis is classified into enterolysis including omentolysis and female reproductive reconstruction (salpingo-ovariolysis and cul-de-sac dissection with excision of deep fibrotic endometriosis).
*Bowel adhesions are divided into upper abdominal, lower abdominal, pelvic, and combinations. Adhesions surrounding the umbilicus are upper abdominal as they require an upper abdominal laparoscopic view for division. The extent, thickness, and vascularity of adhesions vary widely. Complex and intricate adhesive patterns exist with fusion to parietal peritoneum or various meshes placed there]


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## Anastasia

Look at 44180. If it was gyn-related, I'd use 58660. Show these to your physician.  I will let you know that in Pennsylvania, 44180 is not covered in an ASC setting, only in an outpatient hospital. Check with the insurance carrier also.


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