Ob-Gyn Coding Alert

Question: How should I code for a total abdominal hysterectomy, bilateral salpingo-oophorectomy and lysis of adhesions in the cul-de-sac?

California Subscriber
 
Answer: Lysis of adhesions is normally included in any abdominal surgery unless they have been documented as dense, vascular, anatomy-distorting or extensive by the physician who removed them. In that case, you would add modifier -22 (unusual procedural services) to 58150 (total abdominal hysterectomy [corpus and cervix], with or without removal of tube[s], with or without removal of ovary[s]), as it is the only procedure you can bill for. Without documentation of the nature and extent of the lysis, you cannot append modified -22 and request additional reimbursement.