Ob-Gyn Coding Alert

Question: My physician performed an abdominal bilateral salpingo-oopherectomy (BSO) with extra dissection of bad adhesions that necessitated a repair of serosal/muscular bowel injury. How should I code this other than 58720 for the BSO to get a reimbursement for the extra work?
New York Subscriber    Answer: You can bill for the adhesiolysis if the physician has adequately documented the extent of the additional work by adding modifier -22 (unusual procedural services) to 58720 (salpingo-oophorectomy, complete or partial, unilateral or bilateral [separate procedure]). If in addition to lysing the adhesions your surgeon also repaired a bowel injury he or she caused during the lysis and if this is a Medicare patient, you cannot bill for repairing the error. If the bowel injury was already there, you can also bill 44602 (suture of small intestine ...) or 44604 (suture of large intestine ...) depending on the size of the bowel.