Wiki 44005 with another code

[nauger]

When billing for 2 procedure code (one of which is the 44005 - enterolysis) I am never paid for the 44005. I've tried both modifier 51 & 59 and also billing without a modiifer and am denied everytime.
The frustrating part is that I am always paid for the other code when the 44005 pays more.
For example,
44340 (Revision of Colectomy)
44005 (Enterolysis)

Medicare contiues to reject the 44005.

Any help would be very much appreciated!

 

[mmelcam]

If your physician is doing a procedure and finds adhesions and performes a lysis of adhesions during the procedure, this is included in the main procedure. You can not bill 44005 along with the main procedure, it will always get denied. However if your physician states that while doing the colectomy that there were extensive adhesions and it took him extremely long to free them up, then you could try billing the colectomy with a 22 modifier and up the charges. This would have to be clearly documented in the op note and state the exact amount of extra time spent on the adhesions...example... It took an additional 2 hours to free up the adhesions in order to perform the colectomy. Hope this helps.