Ob-Gyn Coding Alert

Question: I have a repeat c-section that includes lysis of adhesions. My ob-gyn's notes state, -Omental adhesions noted in lower uterine segment and additional areas of adhesions cauterized, exposing an adequate amount of space to do procedure.- I cannot find a separate code for this. Is it billable? If so, what's the correct code? There is no hysteroscopy involved, which is the only code I see for lysis of uterine adhesions.


South Carolina Subscriber

Answer: What you describe are not uterine adhesions, which are located inside the uterus (this is what the hysteroscopic code describes). Instead, they are adhesions in and around the uterus for which the only code is 58740 (Lysis of adhesions [salpingolysis, ovariolysis]). 

Many payers may bundle 58740 into another procedure. You have the option of adding modifier 22 (Unusual procedural services) to the cesarean delivery code to show the extra work involved with the adhesiolysis.