Wiki billing c-section with lysis of adhesions

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dmagill

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do you know if you can bill separately for lysis of adhesions when done at same time a c-section?
Thanks
 
You can bill the two together, but most payers will deny the lysis of adhesions inclusive per NCCI guidelines. The use of a modifier is not allowed. I hope this helps.....
 
In my openion:
Cesarean section is a comprehensive and an unique service. Adhesions on the way of C-section for exposing the uterus and the uterine incisional area becomes a component of C-section performance. In that case the adhesiolysis cannot be reported separately, how ever, adhesiolysis is not a normal course of normal C-section.
But having said that it is not an easy or less time consuming procedure.
It requires extensive work and time to perform.

So it merits for modifier-22 definitely, if not accepted for the adhesiolysis.
With a detailed and pertinent surgical report, it should be accepted either of these.

My request to GR8 is: why modifier not allowed? Could you please give the reason with reference.
 
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