# Multiple small bowel resections



## phoover1955 (Nov 16, 2009)

Medicare PT.....doc did 4 hr exp lap w/loa...he wants up charge w/22-modifier. also did small bowel resection x 2....can we charge x 2 for this??
and if you bill the exp lap, doesn't that get bundled to the LOA or vice versa?? 

Thanks, Pat H.


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## lindacoder (Nov 16, 2009)

I would charge 44120 and 44121 for the small bowel resections and up the charges with a 22 modifier, send letter and op note noting the extensive lysis of adhesions


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## bran1120 (Nov 16, 2009)

I would need to read the op note to determine proper coding.  Were the SBR x 2 caused by the LOA or were the resections planned?  If the SBR were medically necessary then I would agree with the above post.  If the resections were due to iatrogenic injuries then I would code the LOA w/a 22 modifier.  You can check the edits but I believe the LOA is bundled with the SBR x 2 (44120, + 44121) and the ELAP is bundled as well.


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