Reader Question:
Medical Necessity
Published on Thu Aug 01, 2002
Question: Can I bill for all of the following procedures? Laparoscopy with salpingostomy with fulguration with lysis of adhesions Chromotubation. Arizona Subscriber Answer: There is nothing wrong with billing all the procedures you have listed, if each is medically justified by at least one diagnosis code.
Chromotubation will not be paid unless it is performed as a diagnostic procedure before starting the surgical part (that is, it will not be paid if it was done to see if the tubes were open after the removal of the endometrial implants or adhesions).Many payers will also not reimburse separately for lysis of adhesions, but if they were extensive and well documented in the operative report, you can add modifier -22 (Unusual procedure services) to the primary surgical procedure, which is 58673. Remember to add modifier -51 (Multiple procedures) to all of the rest of the procedures you bill for.